The first six months of 2015 have been chock-full of digital health news. What follows is an exhaustive recap of the first half of the year with links to MobiHealthNews coverage of notable events throughout. If you'd prefer to navigate to a particular section, here's where you can find our digital health news round-up section for payor news, pharma news, government and regulatory news, mergers and acquisitions, funding announcements, and survey results, market data, and other industry metrics. Or read on below for our round-up of healthcare provider-focused digital health news.
Digital health providers news for 2015 H1
So far in 2015, there's been a lot of movement from hospitals and other provider groups toward adoption of digital tools. While some of the most high-profile provider moves have revolved around the various launches from Apple -- Apple HealthKit, ResearchKit, and the Apple Watch -- plenty of individual health systems have also been making their own announcements with smaller startups or from within their own in-house incubators.
Trend: App curation and hospital app stores pop up
As more and more mobile health apps have emerged in recent years, a perennial question is who will step up to help consumers figure out which health apps are worthwhile. This year we've started to see a trend of providers stepping into that role.
The first two of these moves actually happened last year: Ochsner Health System in New Orleans made headlines when it launched the O Bar, the first “Genius Bar-type” in-person center for learning about health and wellness apps. By February the hospital had a roster of two to three hundred apps it’s recommending. The apps run the gamut from food and nutrition tracking, to fitness and activity, to apps that help manage chronic conditions like diabetes. Some help users quit smoking while others offer support and education to expectant mothers.
And toward the end of last year, Morristown Medical Center, a part of the Atlantic Health System in New Jersey, opened up HealtheConnect, an on-site, physical store located just off the hospital’s main lobby where patients, family members, and medical professionals can learn about health apps and wearable devices. While the store is currently backed by the hospital's foundation, the longterm plan is to transition it into a business and revenue stream in its own right — in about a year’s time.
In April, the Cleveland Clinic got in on the game when Cleveland Clinic Innovations, a business unit at the Cleveland Clinic, partnered with the Global Healthcare Innovations Alliance to launch a new e-commerce platform called ADEO. Through the website, both caregivers and patients will be able to purchase care tools, including a number of patient-facing mobile apps. The store quietly launched last October and now plays host to 13 products.
Some non-provider organizations that were already offering app prescription platforms also made news during the half.
In January, Palo Alto-based HealthTap released a ranking of health, wellness, and medical apps based on the public endorsements of thousands of doctors who use the HealthTap AppRx platform. Although not every doctor in HealthTap’s network participated and those that did, didn’t see all the apps, the system is designed to give each app equal exposure and to minimize bias on the part of physician reviewers.
The top three consumer-facing iOS apps recommended by HealthTap doctors were MyFitnessPal, Weight Watchers, and Lose It! (in that order), while the Android list had Weight Watchers in the number one spot, followed by White Noise Lite and Lose It! once again at number three. White Noise Lite came in 4th on the iOS list, and The American Red Cross First Aid app and RunKeeper rounded out the top six and top five, respectively.
In May, IMS Health, a multinational big data and analytics company, partnered with Quantia, developer of a web and mobile community for physicians. Through this partnership, Quantia provided the 225,000 members on its network with access to IMS’ app curation platform, AppScript.
And across the pond in England, both the NHS England and the Royal College of Physicians both made moves towards curating approved apps for patients. In March, NHS England launched a library of five approved apps on its NHS Choices website, which gets 40 million visits per month. Then in May the Royal College of Physicians of London, the professional organization that sets the standards of medical training in the UK, published a set of guidelines about how doctors there should use medical apps. The two-page guidance document places a heavy emphasis on the CE Mark, but also places the onus on doctors to use their own judgment in using apps in clinical practice.
Trend: Video visits and the return of the house call
Several hospital systems this have invested in one way or another in telemedicine. Minneapolis, Minnesota-based health system Fairview Health made a “significant” strategic investment in January in telemedicine company Zipnosis, which it has been working with the past several years. The amount of the investment was not disclosed. And later in the month Philadelphia’s Thomas Jefferson University Hospital, a 1,000 bed facility with $2.1 billion in operating revenue, invested $20 million to build two new urgent care centers and to create a video visits program that would enable the hospital to help patients while keeping them out of their physical facility.
California health system Sutter Health launched a new iOS app in February that includes telemedicine via MDLive, a company Sutter invested in early last year.The app, for iPhone, iPad and iPod Touch, includes a symptom checker, access to a My Health Online patient portal via Epic, and the aforementioned video visit capabilities. It also has geographic locators for doctors, labs, and other care centers. And MultiCare Health System announced in April that it would offer video visits to Washington-based patients via Doctor On Demand.
In June, the Cleveland Clinic released a new video visits app for Ohio residents, called MyCare Online, that offers patients 24-hour access to a medical professional for urgent care needs. The service is powered by American Well.
And this quarter saw the launch of a couple of apps that could be the next generation of video visits: a return to the house call, now aided by digital tools. San Francisco-based FirstLine Medical launched its doctor consultation service, called FirstLine, available via iPhone app. The offering allows patients to call, text, or video chat with a doctor, similar to other doctor consultation offerings, but FirstLine goes one step further — if users choose, they can also request a doctor to make an in-person visit to their home or office. And Pager, an NYC-based company that raised $10.4 million in March, functions similarly, starting out with a phone call and sending a physician to the user's door if needed.
And, also on that note, Somerville, Massachusetts-based eye diagnostic tool maker EyeNetra launched a new service called Blink, which brings eye tests to the patient, in New York City. Blink emphasizes that the appointments are only for users who need to be tested for glasses, not eye health.
Toward the end of H1, the American Medical Association had a chance to weigh in on the ongoing regulatory conflicts around telemedicine, but ultimately didn't lay down any guidelines. The AMA’s ethics council attempted to come to an agreement over a set of guidelines focused on ethical considerations related to the use of online or mobile visits between patients and physicians, but a physician from Texas helped convince the committee to rethink its plans. The guidelines were tabled and sent back to committee for further review.
The very end of June saw German company Bosch officially closing its US subsidiary Robert Bosch Healthcare, reducing the scope its healthcare operations to a 50-person team based in Germany. Bosch began offering the Health Buddy chronic disease management system after acquiring it about eight years ago.
Trend: Patient-facing apps on the rise
A number of hospitals, particularly children's hospitals have been releasing patient-facing mobile offerings this year to increase engagement.
Miami Children’s Hospital has been developing mobile tools for patients for several years, but in a January interview CIO Edward Martinez said the most recent feature that they plan to release is a virtual discharge option so that the hospital can record a video of the discharge process. This way, parents of patients can better remember instructions from their child’s care team. Another app Miami Children’s has created is a care coordination app for its clinicians, which allows providers who are finished with their shift to enter information about a patient’s condition quickly on a mobile device and pass it to the next clinician. Parents can also keep tabs on those transitions via an app called Care Notes and, as a result, stay up to date on their child’s condition.
In March, Reiter, Hill, Johnson & Nevin (RHJN), an OBGYN private practice in Washington, DC, inked a deal with Washington DC-based Babyscripts, which offers a “Mommy Kit” that includes its pregnancy app and partner connected health devices. The provider will equip its patients with a kit, called Mommy Kit, that includes a smartphone-connected weight scale and connected blood pressure monitor. The devices are either from Withings or iHealth depending on which the customer prefers.
In March, an article in the Wall Street Journal highlighted three different hospitals using tablets in their ICUs: Project Emerge, at Johns Hopkins University, the Patient-Centered ToolKit at Brigham and Women’s Hospital, and MyICU, a project under development at Beth Israel Deaconess. In developing these projects, each hospital found that patients often feel like they’re treated with a lack of respect and dignity in the ICU. Mobile software that allows patients and families a direct line to their care team — that doesn’t involve physically tracking down a busy ICU doctor or nurse — lets families air those concerns and allows hospitals to become progressively better at ameliorating them.
Also in March, Phoenix Children’s Hospital announced that it will install 200 tablets in patient rooms to provide patients and their families with customized, interactive information about their treatment plan. Phoenix Children’s Hospital will digitize its “Journey Boards”, which are tools that help a child’s family understand discharge instructions before they take their child home from the hospital. Currently, the instructions are printed out and distributed to patients and their families.
Finally, Boston Children's hospital showed off a number of innovations at its second annual Innovator’s Showcase in April, including RNSafe, an app for nurses which aims to help increase patient safety when administering medications; Thermia, a decision support tool for fevers and associated febrile illnesses, for example respiratory and gastrointestinal illnesses; an algorithm that can detect seizures in patients with epilepsy based on data from health monitoring wearables; and AudioHub, a clinical audiology app.
Trend: Chronic condition management gets increasingly connected
Finally, a number of health systems adopted connected devices aimed at helping users manage a particular chronic condition. But the half actually started with one such company shutting down its spinoff due to lack of interest. Michigan’s integrated health system Spectrum Health announced at the end of the year that it would shut down Ideomed, a mobile health app developer that spun out of the provider in 2010. According to a report in local business journal MiBiz, Spectrum pulled the plug after “tepid sales” and a lack of interest from outside investors. Ideomed had built an app called Abriiz aimed at asthma and COPD patients.
Yet two other hospital services embarked on respiratory-related projects during the half. In March, LifeMap Solutions, a San Jose, California-based company, launched a new pilot with Mount Sinai Hospital in New York. LifeMap will team up with Mount Sinai’s Icahn School of Medicine and the National Jewish Health Respiratory Institute (NJHRI) to develop a COPD platform that includes both a mobile app and, down the road, a smart inhaler. And in May, Aliso Viego, California-based Sentrian, the remote patient monitoring company formerly known as Jointly Health, announced that it would work with Scripps Translational Science Institute to study its technology on 2,000 patients with COPD. The Sentrian Remote Patient Intelligence platform uses biosensors to monitor patients remotely, but the company uses machine learning to customize the alert parameters for each patient.
In April, several hospitals announced apps and online tools aimed at a number of different chronic conditions including heart disease, diabetes, and obesity.
Brigham and Women’s Hospital in Boston announced plans to pilot iGetBetter’s apps to reduce hospital readmissions through remote patient monitoring and post-discharge patient engagement. The pilot will target patients that have heart disease, specifically those with hypertrophic cardiomyopathy (HCM). The University of Massachusetts Medical School (UMMS) began a pilot of an app, called Sugar, which aims to help people with diabetes manage their weight and blood sugar level as well as assess the status of chronic foot ulcers. And the CS Mott Children’s Hospital at the University of Michigan is announced a new telemedicine program to help reduce childhood obesity. The hospital will work with Fruit Street, a recently-formed digital wellness and telemedicine platform, to provide a program for patients that integrates video visits with monitoring via wearable devices.
Trend: Apple and Google court healthcare more directly
Between an enterprise partnership with IBM, the continued integration of Apple HealthKit into hospitals, the announcement of ResearchKit, and even some early hospital pilots for the Apple Watch, Apple's footprint in healthcare was bigger this year than ever before. Google, meanwhile, continued to play around the edges of healthcare with moonshot projects from Google X, the Google Baseline study, and Google Glass which, though it may be on life support for consumers, still appears to have legs in healthcare enterprise. You can read more about some of Google's exploits during H1 in our pharma section below.
Many of Apple's healthcare launches this quarter build on plans announced last year: Apple's partnership with IBM to develop enterprise apps was announced last year, but only in the first quarter of 2015 did the companies unveil their first batch of healthcare apps. These include Hospital RN, which helps nurses manage patient information; Hospital Lead, an iPad app designed to help charge nurses manage the nursing staff; Hospital Tech, an iPhone app for connecting nurse technicians to the rest of the care team; and Home RN, an iPhone app for nurses working in patients’ homes or otherwise outside the hospital. In May, Apple added an Apple Watch extension to Hospital RN, with plans to do the same for other enterprise apps.
Apple HealthKit, and its associated app Apple Health app, were also announced last year, at Apple's WWDC event. A big part of the initial announcement was integration with Epic which would allow a number of hospitals to make use of the data sharing platform. In February, a Reuters report asserted that at least 14 hospitals were either actively involved in a HealthKit pilot or in talks to roll one out, including Oschner Medical Center in New Orleans, Stanford Children’s Hospital, Penn Medicine, Duke University Hospital, Johns Hopkins, Mt. Sinai Hospital, and the Cleveland Clinic.
Just a few days later Stanford officially launched its patient-facing, HealthKit enabled iOS app. The new iOS 8 app, called MyHealth, allows patients to review test results and medical bills, manage prescriptions, schedule appointments, and conduct video visits with a Stanford physician, the latter via the hospital’s ClickWell Care telemedicine service. The Apple integration allows patients to upload vital signs and have them automatically and securely added to the patient’s chart in Epic.
Later in the half, in April, Cedars-Sinai Medical Center in Los Angeles took a new tack on HealthKit: opening up HealthKit functionality to all of its patients, and letting them tell doctors what data they want to share. Initially, any Cedars-Sinai patient who uses the Epic patient portal will be able to upload data from their devices to the weight, blood pressure, steps, pulse, glucose, and SpO2 fields in HealthKit and have that information sent to the EHR. More than 87,000 Cedars-Sinai patients are active users of the patient portal, and will now be able to integrate their health records with HealthKit.
Apple did launch two new health-related products this year: the Apple Watch and Apple ResearchKit. Apple Watch launched with as many as 264 health and wellness-related apps, but also began to be used here and there in hospital pilots. Two of those focus on cancer: the MedoPad Apple Watch app being used at King's College Hospital in London and Southern New Jersey’s MD Anderson Cancer Center at Cooper, which set up a program for 30 of its breast cancer patients that equips them with Apple Watches to help them self-manage their treatment as well as stay better connected to their care team and each other. The center is working with Wayne, Pennsylvania-based behavioral health technology company Polaris Health Directions on the nine-month feasibility study, which will move into a Phase 2, randomized control trial if it goes well.
And Ochsner Health System in New Orleans, which already has a HealthKit integration and a genius bar-style app and device store for patients, also launched an Apple Watch pilot. The watch will be given to high blood pressure patients, who will use it for medication reminders as well as using the Watch’s built-in fitness software to remind them to get enough exercise each day. Chief Clinical Transformation Officer Richard Milani told Forbes he plans to recruit two dozen patients and use the rest of Ochsner’s existing HealthKit program as a control group to collect data about the effectiveness of the Watch specifically.
In March, Apple announced a new, open source platform for medical research called ResearchKit, which integrates with Apple’s previously launched health data exchange HealthKit. Apple had already begun working with about a half dozen healthcare systems to create specific disease research apps.
The University of Rochester and Sage Bionetworks worked together to create the Parkinson’s research app, mPower, which aims to make it easier for people to sign up for studies and providing consent to do so. Massachusetts General Hospital used ResearchKit to build a diabetes research app called GlucoSuccess. Stanford and the University of Oxford used it to create a heart disease research app called MyHeart Counts. Mount Sinai Hospital and Weill Cornell Medical College teamed up to create an asthma research app called Asthma Health. And Dana Farber Cancer Institute, UCLA School of Public Health, Penn Medicine, and Sage Bionetworks created an app for breast cancer survivors called Share the Journey.
Various voices in the media reacted to the news with a lot of questions and concerns, but ResearchKit has pushed through. The platform became widely available to researchers in April, and toward the end of that month Apple made some new rules to address concerns about vetting of ResearchKit projects. The company added guidelines stipulating that all studies conducted via ResearchKit must obtain prior approval from an independent ethics review board.
News broke about one more ResearchKit study at the end of the second quarter: A longitudinal study of lesbian, gay, bisexual, transgender, queer (LGBTQ) and other sexual and gender minority (SGM) adults to examine how their sexual orientation affects their health, conducted by UCSF. The study is called PRIDE and stands for Population Research in Identity and Disparities for Equality.
Google's news in the provider world mainly concerned Google Glass. In January, Google made a controversial announcement about Google Glass: that the Explorer program (by which consumers were able to get access to the devices) was shutting down, and Google Glass would move out of Google’s experimental Google X Lab to become their own Google Team, under Nest creator Tony Fadell. Though many in the media were ready to declare Google Glass dead, for the healthcare space (and enterprise in general) reports of Glass's death were greatly exaggerated. Augmedix and Pristine, two companies working on Glass applications in healthcare, said they were bullish about Glass's future.
And just a month later we saw some validation of that optimism. After two and half years of negotiations with Google and with the Illinois Department of Public Health, a Skokie, Illinois ambulance service rolled out a program to give doctors live access to paramedics’ points of view via Google Glass. The Medical Express Ambulance Service, or MedEx for short, uses software developed by Pristine and is working with The Advocate Illinois Masonic Medical Center in Chicago at first, but plans to expand into additional hospitals in the future.
Then in April, a feasibility study published in JAMA dermatology showed that patients are overwhelmingly satisfied with dermatology consults via Google Glass, even preferring them to consultations over the phone. Twenty-nine of the patients 31 patients in the study (93.5 percent) were satisfied overall with the procedure and 30 (96.8 percent) were confident in both the accuracy of the video equipment and the privacy of their information. Twenty-eight people said they would recommend the Google Glass consultation to others.
At the very end of the quarter, the Google X life sciences team, which is the same team behind the Baseline study, announced that it's building a wearable health sensor for cardiac and activity tracking. Google’s device is a clinical-grade sensor designed for investigational use. The wristworn sensor will measure pulse, activity level, and skin temperature continuously. It will also be able to take an ECG and pick up on environmental information like light and noise levels, which might indicate to investigators that a person isn’t wearing the device or isn’t leaving their house much. Google will investigate different research cases for the device, including sending it home with discharged patients at risk for readmission.
Other provider news from H1
Not all the digital health news from the past two quarters fit into a neat set of trends, and several individual hospitals made a disproportionate splash. For instance, Cleveland Clinic and Partners HealthCare in Boston each had a number of partnerships launch during the first six months of the year.
In February, telecom giant Cox Communications announced that it was teaming up with the Cleveland Clinic to form a “strategic alliance”, called Vivre Health, that would develop digital home health services. The joint venture will be based in Atlanta and will help Cox move its healthcare business beyond providing broadband services to hospitals, according to Reuters. As part of the announcement Cox disclosed that it had also made an investment in health kiosk company HealthSpot, but the amount remains undisclosed. And that wasn't the end of kiosk-related news for Cleveland Clinic. At the end of March, health kiosk company Pursuant Health (formerly SoloHealth) teamed up with Cleveland Clinic Wellness to incorporate its kiosks into Cleveland Clinic Wellness's employee health offerings.
Partners HealthCare started the year with some internal restructuring that made the Center for Connected Health move from being a technology group that supports care offerings to being an integrated connected care group within the hospital. But the groups big news was a series of partnerships with Samsung, pharma company Daichii Sankyo, and PatientsLikeMe.
The Daichii Sankyo partnership was actually announced last year. The two companies announced in October they would work together to create a mobile app for atrial fibrillation patients taking oral anticoagulants from Daiichi Sankyo. The app will have the goal of improving medication adherence and compliance and improving patient-provider communication and feedback loops.
With Samsung, the companies announced in April that the Boston-based integrated health system will work with the electronics giant to create chronic condition management software. Partners plans to launch a clinical trial of the new software in June. Finally, the PLM partnership, announced in May, will provide patients with access to PatientsLikeMe via the healthcare provider’s patient portal. As part of the deal, Partners’ Patient Gateway will connect patients into PatientsLikeMe’s system.
A few hospitals continued to experiment with the boundaries of how much access a patient should have to his or her own data. In January, Boston’s Beth Israel Deaconess Medical Center received a $450,000 grant from The Commonwealth Fund this week to develop a program called OurNotes that allows patients to contribute to their medical records. The program is an extension of the well-known OpenNotes initiative and will include collaboration with a handful of other providers across the country. And in May, Children’s Hospital Los Angeles (CHLA) announced that they woudl offer an imaging app, called ImageInbox, to their patients. The app will help patients access digital versions of their imaging records, including MR, CT, ultrasound, and x-ray files.
Another two hospitals tested out devices and apps for surgical or therapeutic rehabilitation. Florida Hospital, a 2,200-bed acute-care medical facility and a member of Adventist Health System, began testing a shoe-based wearable sensor from Seattle-based Reflx labs to assist in pediatric rehabilitation. The platform, called Boogio Bionic Foot Sensors, consists of foot pressure, balance and 3D movement sensors hidden in a user’s shoe. They connect to a mobile app, allowing doctors or physical therapists to track a patient’s progress. And McGill University Health Center in Quebec, Canada partnered with SeamlessMD, a company that has developed an engagement tool for surgery patients, to test the efficacy of a tablet app for enhanced recovery after surgery.
Additionally, researchers from Northwestern University launched a study in February that aims to analyze how monitoring the physical activity of patients who underwent spine surgery, using Fitbit activity trackers, could help them predict the patient’s recovery time.
Several new joint ventures launched around digital health in the half in addition to Cleveland Clinic's Vivre Health. In March, GE Ventures and Stanford Health Care teamed up to create Evidation Health, a company focused on evaluating the efficacy of digital health technologies. Soon after Evidation was formed it merged with wellness engagement platform company The Activity Exchange. And in May, Meridian Health subsidiary iMPak Health teamed up with biomedical and healthcare technology group NetScientific to create a new digital health sales and marketing company called Triventis Health. Triventis will market combined offerings from iMPak and Wanda Health, a subsidiary of NetScientific, relying on Wanda Health’s offerings for data analytics and IMPak’s easy-to-use devices for remote monitoring. The product offerings will be rolled out first at Meridian Health hospitals, and then marketed to different hospitals around the country.
In May, Brigham and Women’s Hospital partnered with seed fund Rock Health to test and possibly integrate technologies from companies in Rock Health’s portfolio. The two organizations will launch the partnership this sumer and it is expected to last three years.
Finally, later that month, the University of Rochester, including the University of Rochester Medical Center, partnered with Cambridge-based stretchable sensor company MC10 to test the company’s BioStamp platform in clinical settings and help it develop its disease-specific algorithms for predictive health analytics.
Digital health efficacy studies from H1
In addition to testing new and interesting technologies, hospitals during the quarter also carried out a number of efficacy studies to assess the outcomes of existing mobile and digital health interventions.
In January, smartphone ECG company AliveCor announced the publication of a long-awaited independent trial of the technology conducted by the Cleveland Clinic. As was reported at Heart Rhythm Society in May 2014, the trial showed that AliveCor’s heart monitor detected atrial fibrillation that was present 100 percent of the time, and only returned false positives 3 percent of the time.
In February, a systematic review of patient portal studies found that research conducted on patient portals in the last three years shows they provide some measurable benefits, but studies are spotty and don’t include a single randomized control trial. Then in June, a small study found that even when 80 percent of the patients made use of the mobile patient portal provided to them, it didn’t make them that much more knowledgable about things like their care plan or their medications. The only significant benefit of the portal was that users were more likely to know the name of their doctor than members of the control group were.
By contrast, another study that same week found that online patient community PatientsLikeMe was able to increase epileptic patients' self-management and self-efficacy, though the study did have problems with engagement and follow-up in the study group. On a similar note, in an ongoing study, the University of Pennsylvania will test whether online social accountability enhances patients' adherence to regularly checking their blood pressure.
Another systematic review came out in March, this one analyzing text message interventions, but there the outlook was better: A majority of published text message interventions between 2009 and 2014 that addressed diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence were effective, according to the study.
In other text message news, adding educational health content to text reminders for influenza vaccines improves the effectiveness of those texts, when compared with written reminders and texts that do not offer extra health information, according to a study of 660 children published in January in the Journal of the American Academy of Pediatrics.
In addition to the two systematic reviews, Mayo Clinic Proceedings published a meta-analysis showing that, in general, digital health interventions can be of great benefit in improving outcomes for cardiovascular disease. Mayo Clinic researchers poured through 588 abstracts from the past 25 years, eventually winnowing them down to 51 RCTs and cohort studies, encompassing 24,000 patients. Researchers found that, on average, digital health interventions (which included telemedicine, Web-based modalities, email reminders, SMS texting, mobile application, and data monitoring) reduced relative risk for cardiovascular disease outcomes by 40 percent — a better reduction than statins, aspirin, or antihypertension drugs.
A study conducted in February at the Columbia University School of Nursing found that using mobile apps that help clinicians follow evidence-based guidelines when making treatment decisions increases the chances that nurses will identify patients with chronic health issues, including obesity, smoking, and depression. Also in February, a survey of 526 registered nurses, commissioned by the Gary and Mary West Health Institute and conducted by Harris Poll, suggested that lack of medical device connectivity and interoperability are big contributors to preventable medical errors, and that nurses end up shouldering a lot of the burden of medical devices and electronic health records that don’t integrate well together.
An interesting study conducted in March by Health Affairs found that different hospital ratings lists are wildly inconsistent with one another. The study looked at U.S. News & World Report’s Best Hospitals; Healthgrades’ America’s 100 Best Hospitals; Leapfrog’s Hospital Safety Score; and Consumer Reports’ Health Safety Score. Furthermore, in 27 cases a hospital was nearly at the top of one list and towards the bottom of another.
April was a big month for reducing readmissions for congestive heart failure. New York City-based Health Recovery Solutions announced that its tablet-based program reduced the 30-day readmission rate for 130 congestive heart failure (CHF) patients at Penn Medicine’s Penn Care at Home program by 53 percent. Then, in a pilot that included more than 350 CHF patients, a Philadelphia hospital was able to reduce its 30-day readmissions by 10 percent — a 40 percent improvement over baseline — by using email and text message reminders to get patients into follow-up appointments. Then a retrospective matched-pair cohort study of 348 patients in Partners HealthCare’s Boston-area hospitals showed that remote monitoring in congestive heart failure patients can reduce 120-day hospitalizations and mortality. Interestingly, while the reduction in mortality held beyond the 120 days of the study, the hospitalizations for the monitoring cohort actually went up after the monitoring stopped.
Finally, in June, a small study found that patients with diabetes may be more likely to benefit from a mobile phone-based health coaching program with remote monitoring than patients with heart disease. According to researchers, “the majority of the patients adhered to the home telemonitoring plan and frequently monitored at least one of the required health parameters,” but “the intervention showed no statistically significant benefits over the current practice with regard to health-related quality of life”.
Health insurance company digital health news for H1 2015
While it's not a health insurance company, life insurance firm John Hancock broke new ground in the life insurance industry a few months ago when they announced a new service via a partnership with The Vitality Group, a US subsidiary of South Africa’s Discovery Health, that will provide members with discounts based on their activity tracking data. Members will get a free Fitbit from their insurer, and will have the opportunity to earn points for different healthy behaviors, which can earn members a 15 percent premium discount in addition to other perks. Other ways to earn points include regular gym visits, not smoking, and keeping blood glucose, blood pressure, and cholesterol in ideal ranges.
Earlier this year, AmeriHealth District of Colombia, Washington, the largest Medicaid managed care organization in the district, launched a text messaging software offering aimed at improving medication adherence for asthma patients who are also members. The platform, called HealthNHand, was developed by Memotext and was launched by pharmacy benefit management company PerformRx. HealthNHand will use interactive voice responses, email, and text messages to remind asthma patients in the program to take their medication and to fill out questionnaires about their health.
UnitedHealthcare made news a number of times in the first half of 2015.
At an HxRefactored event, UnitedHealth Group Vice President of Innovation and R&D Kunjorn Chambundabongse discussed the strategy behind the payor’s internal incubation group and revealed one of the group’s newest projects, a vending machine that will sync up with employee wellness plans.
That same week, AARP launched a new research initiative, called Project Catalyst, where the organization will work with partners including Pfizer, UnitedHealthcare, and Georgia Tech to promote an increased focus on users over 50 in digital health research and development. The first project of the new initiative, focused on sleep and activity trackers, is launching at Georgia Tech.
Shortly afterwards, UnitedHealthcare announced a partnership with Walgreens, wherein UHC members in Arizona and Illinois have access to Walgreens Balance Rewards program, directly via their Health4Me app from UHC.
And at the end of April, UnitedHealthcare announced that it would cover video visits from Doctor On Demand, American Well’s AmWell, and its own Optum’s NowClinic, which is a white-labeled American Well offering. The insurance company pointed out that the average price of a video visit is less than $50, and as part of its coverage for the service its members will still be responsible for a portion of that fee depending on the deductibles, copays and out-of-pocket expenses associated with their specific benefit plan.
Other major insurers also made news so far this year including Humana, Aetna, Cigna, and a few of the Blues.
Humana partnered with Weight Watchers to integrate the weight loss program into various services for members, including its HumanaVitality wellness platform. Humana will make the program available to its members in qualified employer-sponsored health plans.
The payor also launched a new lab dedicated to making sure HumanaVitality and other apps from the insurance giant have the same nimble development protocols as apps developed at a small startup would. The new space houses 11 full-time employees and supports four more who work remotely, but could hold up to 40.
Aetna announced a collaboration with Newtopia that’s moved out of the pilot phase and into full implementation. Around the same time it updated its iTriage app by adding price comparison features for select users.
Aetna business unit iTriage released data from a survey of 3,300 of its users — a sample of individuals who, as iTriage users, have already adopted mobile health tools — and found that only 48 percent of their iOS users use Apple Health. What’s more, 27 percent have never heard of it.
Cigna updated its health coaching app, called Coach by Cigna, which aims to help users improve their health by making healthier lifestyle decisions. Coach by Cigna previously collected health information either manually through the smartphone or via sensors in wearables like Galaxy Gear or Gear Fit to generate a personal health coaching regimen for users. But the new version uses “psychology of lateral assessment” to determine the user’s personality type, wants and needs, as well as preferences, so that Cigna can profile the user more accurately.
A study conducted by health app intervention developer ORCAS with help from insurance company Cigna found that a mobile intervention, called FitBack, that personalizes health content for the user is an effective tool to help patients improve their nonspecific lower back pain (NLBP).
Blue Cross Blue Shield of Michigan inked a deal with WebMD’s Health Services this year to offer members a digital health and wellness program. Blue Cross and Blue Care Network members will also have access to a portion of this new program. WebMD’s Health Services program helps employers and health plans provide employees and members with information about their benefits, biometric screenings powered by BioIQ, health assessments, a digital assistant, and health-related content. These tools will be added to BCBS of Michigan’s wellness program, which allows members to check their coverage, monitor claims activity, and shop for doctors as well as health care services.
Another Blue, Blue Cross Blue Shield of Massachusetts, partnered with American Well to pilot the company’s video visits offering, called WellConnection, with two physician groups, Emerson Physician Hospital Organization (Emerson PHO) and Lowell General Physician Hospital Organization (LGPHO). BCBSMA nurse care managers will also pilot the offering with members. WellConnection is a white-labeled version of American Well’s digital video visits offering that helps patients consult with physicians via their computers, smartphones, or tablets.
Meanwhile, Blue Cross of Idaho launched an app, available on iOS and Android devices, for its members so they have access to information about their healthcare plan. The health insurer tapped Kony and UST Global to develop the app. Members are able to log in to the app to see their plan benefits, find in-network or out-of-network doctors, and access their member ID cards. Users can also search for providers and urgent care centers by location, name, or specialty, view benefits details, and check their annual deductible.
Independence Blue Cross Center for Health Care Innovation invested $2.4 million in West Conshohocken, Pennsylvania-based chronic care app developer CareCam Health Systems. Independence Blue Cross plans to work with CareCam to develop programs that aim to improve the care of people with chronic health conditions. CareCam’s initial rollout with Independence is focused on supporting members with diabetes and asthma.
Later, at an event in Philadelphia, Independence Blue Cross lead researcher Aaron Smith-McLallen discussed patient engagement strategies. He pointed out that by understanding the most effective intervention for each group of patients, payer groups like IBC can find the sweet spot to spend money only where it will produce results.
And Dr. Sachin Jain, who left his position as Merck’s Chief Medical Information and Innovation Officer earlier in the year, started work as Chief Medical Officer of CareMore Health System. CareMore, a subsidiary of Anthem, is an integrated care plan that combines a Medicare Advantage plan with 24 care centers around the country.
An analysis of national claims data from Anthem subsidiary Amerigroup found that Amerigroup Washington members who both had a TracFone Lifeline phone and had enrolled in Connect4health, Voxiva’s health texting program, were three times more likely to attend their annual physical exam within 90 days of receiving text reminders.
VSP Global, a business that operates vision benefits plan VSP Vision Care as well as several other eye care companies, built a pair of glasses with activity tracking sensors built in. The project, called Project Genesis, comes out of VSP’s innovation lab The Shop.
A few employee wellness companies also made moves this year.
Corporate wellness platform Keas launched a new product for self-insured employers, called Health Hub. It aims to be a comprehensive health benefits management platform that incorporates Keas’s existing employee wellness offering as well as health management and reporting, disease management programs, smoking cessation programs, gym memberships, cost transparency tools, and more.
And Health Care Cost Institute (HCCI), a non-profit organization, launched a price transparency website, called Guroo, to help consumers find national, state, and local pricing information for common health conditions and services. The data is collected from 40 million anonymized members of four health insurers: Aetna, Assurant Health, Humana, and UnitedHealthcare.
As the first half of the year drew to a close, a number of the biggest health insurance companies were reportedly eyeing each other for acquisition. While various overlapping potential pairings had been reported, no deals had been officially set in motion as of the last week of June.
For even more news on payors, MobiHealthNews put together an in-depth report earlier in 2015 that explored recent digital health moves by payors.
Pharma's digital health news from the first half of 2015
This year kicked off with some big pharma-related announcements at CES from Novartis and Roche, which both partnered with Qualcomm Life on new digital health endeavors. News also trickled in from Sanofi, Novo Nordisk, Johnson & Johnson, Eli Lilly, and others. And, on the retail pharmacy side, Walgreens made a lot of news this quarter, partnering left and right for its Healthy Rewards program.
Novartis selected Qualcomm Life as a partner for its global Trials of the Future program, in which Novartis is endeavoring to use more mobile technology in its clinical trials and to provide connectivity for future Novartis products. Novartis will use Qualcomm Life’s 2net platform and various connected devices to collect medical data directly from trial participants in their homes.
Novartis also teamed up with Qualcomm Life on an investment fund, which will leverage up to $100 million to invest in “technologies, products or services that ‘go beyond the pill’ to benefit physicians and patients”. The fund is called dRx Capital.
Similarly, Roche will use Qualcomm Life’s 2net platform to capture patient data from connected devices, starting with anti-coagulation meters. In addition to its pharmaceutical business, Roche’s Point of Care product suite includes back-end testing systems for anticoagulants, blood glucose, blood gas and electrolytes, and urinalysis. The Qualcomm partnership will initially focus on anti-coagulation meters but could expand into these other areas as well.
Later in the quarter, Roche, through its venture arm Roche Ventures, also contributed to a $4.8 million round for mySugr, an Austrian diabetes app company. MySugr offers a handful of apps, but its flagship is called Diabetes Logbook, which is designed for people with type 1 or type 2 diabetes and includes logging, graphing, analysis, “exciting challenges”, “smile-inducing feedback”, and Apple Health integration.
MobiHealthNews also learned that Roche has partnered with mobile vision testing startup Vital Art and Science to test the company's myVisionTrak app in a major trial. The study, called the Pivot study, is being sponsored by Roche. It will assess the effectiveness of home vision testing using mVT, and will also help Roche test online patient recruitment procedures, including social media strategies. The goal is to recruit at least 250 patients, and as many as 1,000, according to the study website. It will be a remote trial that won’t require patients to make additional in-person visits.
Biogen Idec also made news with a big research-centered digital health partnership: It announced that it would team up with Google X to use sensors, software, and data analysis tools to collect and analyze data from people who have MS. The companies aim to explore why MS progresses differently in each patient.
The company also did another MS study in collaboration with PatientsLikeMe, using Fitbit devices. It was a non-controlled feasibility study to assess the potential usefulness of wearables in increasing the activity of people with multiple sclerosis, and in tracking their activity outside of a doctor’s office setting.
In the study, 248 patients with multiple sclerosis were given Fitbit One tracking devices and instructions on using the trackers as well as on sharing data to PatientsLikeMe’s online discussion platform. Over the course of the 21-day study, patients used and synced the device about 87 percent of the time. Afterwards, patients were surveyed about their experience and 191 responded. Of these, 88 percent reported that the device was easy to use and incorporate into their daily routine and 83 percent agreed that they would continue to use the device after the study. Sixty-eight percent believed that the device would be useful to them in managing their MS.
Over at Merck, former Chief Medical Officer and Innovation Officer Sachin Jain revealed that he’s moved to CareMore, a subsidiary of Anthem, and an integrated care plan that combines a Medicare Advantage plan with 24 care centers around the country.
Meanwhile, M2i2, the innovation group at Merck Jain led, has been restructured into two separate groups, both led by individuals Jain recruited from the public sector. Dr. Aman Bhandari will lead Merck’s data partnerships while Dr. Thomas Tsang will serve as chief medical officer for Merck Healthcare Solutions and Services, which will house many of Merck’s digital health projects.
Later in the quarter, Sanofi backed a fully remote clinical trial in Europe. Scotland-based eClinicalHealth will run the trial, called the VERKKO trial. The study will test a smart, wireless glucometer from Mendor that coaches patients on checking their glucose after learning from previous readings and schedules. Mendor’s glucometer isn’t smartphone-connected; instead, it has embedded cellular-connectivity and uploads user data directly to the cloud. Investigators can see all the data from the users, and the trial will produce outcomes and compliance data for Mendor.
While Sanofi doesn’t have a drug or a device under investigation, it is providing a good deal of the funding because it’s interested in using eClinicalHealth’s online platform in its own clinical trials in the future. Called Clinpal, the technology supports fully online clinical trials from recruitment to data capture, and notably includes electronic informed consent.
A number of pharma companies talked about some of their digital efforts at the ePharma Summit in New York City at the end of February. Novo Nordisk talked up its Ask.Screen.Now and Cornerstones4Care diabetes education initiatives, which use celebrities and channels like YouTube to spread awareness about Type 2 diabetes.
Partners HealthCare in Boston and Daichii Sankyo shared more about their new partnership for remote monitoring atrial fibrillation patients. The two companies will develop a “mobile wrap-around” for a Daichii Sankyo anticoagulate drug prescribed for atrial fibrillation. Says Partners' Dr. Joseph Kvedar, the intervention will be “cross-therapeutic, but largely will help DSI succeed in the marketplace for their anticoagulate.” Like some of Partners’ other programs, it will involve a wearable monitoring device and an app, through which patients can receive positive feedback from their doctors and from the app itself.
Boehringer Ingelheim Pharmaceuticals, the Connecticut-based US subsidiary of German pharma company Boehringer Ingelheim, announced in May that it's working with Sacramento, California-based health system Sutter Health on a five-year research collaboration that will explore the clinical value of mobile health technology, data analytics, and other digital health tech.
The specific goals of the partnership are to create a system for collecting health data from COPD patients, using either tablets or kiosks, during each health encounter, and then increase the ease with which physicians can communicate with physicians about their disease progression and treatment options. By incorporating the collected data into a visual display, the companies want to empower shared decision making and personalized care.
The second quarter of 2015 has been especially big for Eli Lilly, a major pharma company that's just beginning to dip its toe in digital health. The company made two related moves, both involving drug delivery devices. First it announced the opening of a new drug delivery and innovation center in Kendall Square in Cambridge, Massachusetts. Construction will begin immediately, with the center opening by the end of the year for a planned staff of 30 scientists and engineers.
Then it made an undisclosed investment in San Diego, California-based Companion Medical, a stealthy medical device startup developing a Bluetooth-connected insulin pen and connected app. The company is led by a veteran engineer of Dexcom, Medtronic, and Tandem Diabetes Care, and it intends to improve on the insulin pump for people living with type 1 diabetes.
Johnson & Johnson
Johnson & Johnson company LifeScan quietly launched a clinical trial to determine whether its OneTouch Verio blood glucose meter (or a not-yet-launched version of it) creates a greater reduction in A1C levels when used in conjunction with its companion app.
According to a post on ClinicalTrials.gov, the company is recruiting 148 patients for a randomized control trial that will compare patients using the OneTouch Verio Flex Blood Glucose Management System alone to patients using it with the LifeScan OneTouch Reveal app. Secondary outcome measures include adherence to regular glucose testing, use of the app over 24 weeks in the app group, and patient satisfaction.
In April, Johnson & Johnson was one of several companies to partner with IBM's new Watson Health unit. The focus of the collaboration will be on creating app-based coaching systems using Watson. The initial focus area will be preoperative and postoperative care for joint replacement and spinal surgery. They also plan to launch apps focused on chronic conditions.
Then in June, McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that makes over the counter medications like Tylenol and Zyrtec, released a new mobile app, called Healthyday, that uses crowdsourced data to inform users about location-based allergy, cold, and flu trends. The app is the first to make use of an API from Sickweather, a company that has offered its own version of a health map app for years.
In April, AstraZeneca followed the lead of Genentech to sign a five-year data access deal with patient community PatientsLikeMe. AstraZeneca will have full access to PatientsLikeMe’s global network, and the company will use the data to shape future medicine development and work to improve outcomes in different therapeutic areas, with an initial focus on respiratory disease, lupus, diabetes and oncology.
At the BIO conference in June, Craig Lipset, Pfizer’s Head of Clinical Innovation, shared some information about the fate of 2011's Remote clinical trial, a Pfizer trial that was to have been conducted entirely remotely, but was cancelled because of lack of enrollment. Since 2011, Pfizer has incorporated many successful facets of that trial into its ongoing efforts — and has put the failed aspects out there for other companies to learn from.
“For us, we took away a series of modules that worked and one that didn’t,” he said. “That’s not meant to imply that online medication recruitment is a failure. In this particular protocol going after that particular patient population it did fail for us, but the other components did work. So our priority has been to take those components that did work, whether it’s electronic consent or other components, and scale those up. Because we’ve got 200-some clinical trials ongoing every day of the week, so how can we leverage what did work?”
Though not a pharma company, Walgreens made big news this quarter, inking deals with Glow, PatientsLikeMe, Qualcomm Life, and even video game company Atari. Glow, maker of digital health tools for women, integrated Walgreens’ Prescription Refill API into its app so that Glow users can refill their birth control prescriptions directly from their Android or iOS app. Walgreens added data from PatientsLikeMe to its online health dashboard, giving patients a view of possible medication side effects sourced directly from other patients.
In the Qualcomm Life partnership, Walgreens customers will be able to use 2net to sync certain mobile health devices, including a wrist-worn blood pressure cuff, a traditional blood pressure cuff and a blood glucose meter, directly to their Balance Rewards account, earning points each time they check their vitals. And Atari partnered with Walgreens to offer Balance Rewards points to users who are tracking their steps through Atari’s new fitness app.
A few smaller pharma companies also had news this quarter. News emerged that BioDelivery Science, a specialty pharma company based in Raleigh, North Carolina, released an app back in December to help support recovering opioid addicts. The app, called InReach, is designed to work with the company’s drug Bunavail.
InReach provides a lot of basic medication adherence features, like tracking goals and monitoring progress, tracking moods and medications, and managing appointments. But it also includes a motivational pin board where users can put pictures of family members to remind them why they’re quitting drugs, educational materials for family and friends, and features for identifying and tracking triggers.
My GI Health, a public-private partnership between several universities and Ironwood Pharmaceuticals, shared plans for expanding its patient engagement tools beyond the world of gastrointestinal health and into other conditions.
Finally, in June we learned that a mystery pharma company is working with Scripps Health on a novel clinical trial: one that is actually a behavioral trial, not for patients, but for cardiologists. Its goal is to help Scripps discover what kind of results are necessary to drive adoption of digital health technology among providers.
Other pharma-related news
Even before Apple made its surprise announcement of Apple ResearchKit, a new open source platform for medical research and electronic informed consent, mobile clinical trials were at the center of a lot of news this half-year, over and above the Verkko trial sponsored by Sanofi.
Early in the year, a study of 660 children, published in the Journal of the American Academy of Pediatrics, showed that adding educational health content to text reminders for influenza vaccines improves the effectiveness of those texts, when compared with written reminders and texts that do not offer extra health information. And a recent study from San Francisco-based mscripts and retail pharmacy Avella Specialty Pharmacy found that mscripts mobile pharmacy app helped Avella’s HIV patients to become more adherent to their medication. About 79 percent of those using the app achieved at least 90 percent adherence, while only 65 percent of the patients not using the app posted that rate.
The FDA launched a new app, called DrugShortages, to help health care practitioners and pharmacists track current drug shortages, resolved shortages, and discontinuations of drug products.
In January, ingestible sensor company Proteus Digital Health and computer giant Oracle integrated Proteus’s digital health feedback system, which includes an ingestible pill sensor, a wearable patch, and a software system, with Oracle’s InForm software for data collection. Clinical trial researchers using Oracle’s software will now be able to track patients’ medication adherence with Proteus’s technology.
In addition, Swedish clinical trial recruitment company Trialbee raised $5 million to support its entrance into the US market and Iodine, the crowdsourced medication review company run by former Wired editor Thomas Goetz and former Google engineer Matt Mohebbi, launched a new study to look specifically at the effects of antidepressants.
Several medication adherence companies reported new efficacy data, including HealthPrize, which raised medication adherence an average of 54 percent across a series of pharma-sponsored pilot programs for various medical conditions, with sample sizes ranging from 250 to more than 7,000, and Mango Health, which showed a 20 percent increase in on-time prescription refills for the most at-risk patients in its pilot program, a group of patients with hypertension taking five or more medications. Patients used the Mango Health app an average of 17 times per week.
Government policy and regulatory-related digital health news in H1 2015
Even the highest ranks of government showed interest in digital health offerings this year. In February, President Barack Obama mentioned in an interview with Re/Code Cofounder Kara Swisher that he was considering using an Apple Watch because of its fitness capabilities.
But just a month later, Obama was seen wearing a Fitbit Surge, the Fitbit device with a similar feature set to that of a smartwatch. At the time, though, the Apple Watch had not launched yet. But shortly after it launched, Obama was spotted wearing the Surge again, even though the Apple Watch was available. So far, it looks like the Fitbit Surge may be the the “first” wearable of the US, or FWOTUS.
Department of Health and Human Services
In January, the Centers for Medicare & Medicaid Services (CMS), a federal agency within the United States Department of Health and Human Services (HHS), announced a CPT code for "non-face-to-face care coordination services furnished to Medicare beneficiaries with multiple chronic conditions". The code was defined as chronic care management services that took up at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month. Other requirements included: the patient must have at least two or more chronic conditions, which are expected to last at least 12 months; conditions that placed the patient at significant risk of death, acute exacerbation or decompensation, or functional decline; and a comprehensive care plan established, implemented, revised, or monitored.
In March, the Department of Health and Human Services announced that it would follow up its Pioneer Accountable Care Organization (ACO) Model with a new, Next Generation ACO Model. ACOs operating under the new model will take on more risk than their predecessors, potentially share more savings, and will have greater freedom to be reimbursed for telemedicine.
Nineteen states said they intend to invest more in telehealth this year as they roll out innovative health care delivery services for their Medicare, Medicaid, and CHIP populations. Twenty-five states have created “innovation plans” backed by grants from the Centers for Medicare and Medicaid Innovation (CCMI). Accenture published a report that analyzes the investment priorities of these 25 State Health Innovation Plans (SHIPs).
A few months after Accenture's report, the Office of the National Coordinator for Health Information Technology (ONC) published online resources to help the states that are participating in the State Innovation Models initiative make better use of digital health tools.
The ONC also released the proposed 2015 certification criteria for EHRs. The standards proposed will be optional through 2017 and mandatory for all hospitals in 2018. They have been opened up for public comment. On the same day, CMS announced the long-awaited proposed guidelines for Stage 3 of Meaningful Use requirements for electronic health records.
HHS’ Office of Civil Rights, which oversees the administration of HIPAA, announced they would begin working closely with mobile health companies to make sure HIPAA rules are clear and unambiguous, according to a letter HHS sent to Representatives Peter DeFazio (D-OR) and Tom Marino (R-PA) in November.
The Substance Abuse and Mental Health Services Administration, a branch of the US Department of Health and Human Services, launched a new training tool, an app called Suicide Safe, for behavioral health and primary care providers.
Researchers from the University of Massachusetts Medical School and Worcester Polytechnic Institute developed an app that helps people understand why they are overeating. The team was awarded $2 million from the National Institutes of Health (NIH) for this project. The app, called Relax, is designed for patients who are in clinical programs to lose weight and manage stress.
The National Cancer Institute awarded Jonathan Bricker, a behavioral scientist and faculty member at Fred Hutchinson Cancer Research Center, with a five-year, $3.1 million grant to conduct a randomized controlled trial of SmartQuit, a smoking-cessation app.
As promised in its FDASIA report, the FDA published a draft guidance document that aims to help those creating wellness devices and apps to better understand when their product (or their marketing claims) crosses over into regulated medical device territory.
The FDA also moved to finalize a guidance to further de-regulate a specific type of health software, which included a number of mobile medical apps and telehealth platforms, from FDA-registered Class 1 devices to an unregulated status. The most recent final guidance specifically relates to MDDS software, which the FDA deregulated from Class 2 to Class 1 in 2011.
Bradley Merrill Thompson, who has written extensively about mobile health regulation for MobiHealthNews over the years, offered our readers his initial analysis of these two draft guidance documents.
AliveCor recalled Version 2.1.2 of its AliveECG iOS app under an FDA Class III recall according to an FDA posting that went up in February. But in actuality, the “recall,” which happened in mid-January, was little more than a run-of-the-mill buggy app update, which the company patched within two days. The incident served as an interesting case study for how recalls apply to regulated medical apps.
The FDA launched a new app, called DrugShortages, to help health care practitioners and pharmacists track current drug shortages, resolved shortages, and discontinuations of drug products.
PatientsLikeMe announced a research partnership with the FDA: The agency will assess the platform’s feasibility as a way to generate adverse event reports, which the FDA uses to regulate drugs after their release into the market.
The Federal Trade Commission took action against two melanoma detection apps: MelApp and Mole Detective. Some of the marketers behind the apps have agreed to settle with the FTC, while two additional marketers of Mole Detective have refused. Total settlements for the two apps came to just north of $20,000. Both apps claim to provide an “automated analysis of moles and skin lesions for symptoms of melanoma and increase consumers’ chances of detecting melanoma in its early stages”, according to the FTC.
The FTC also published a report focused on privacy and security issues related to the massive Internet of Things (IoT) trend, which includes the growing number of connected health devices. The report summarizes the discussions that took place at an FTC-hosted workshop in November 2013, and it also includes recommendations for the industry from FTC’s staff.
Shortly after releasing the report, the FTC announced an administrative complaint against Focus Education, a company that makes a brain training game for children called Jungle Rangers. The complaint charges that the company advertised permanent brain improvements in “focus, memory, attention, behavior, and/or school performance”, including for children with ADHD, and backed up the claims with what the FTC said were nonexistent scientific studies.
MobiHealthNews also pointed out that a recent Supreme Court decision could have a profound impact on the ability of state medical boards to prevent telemedicine companies from offering their services, according to some experts familiar with the case. North Carolina Board of Dental (NCBD) Examiners vs Federal Trade Commission was decided by a 6-3 vote last month. The case ruled that medical boards comprised of private professionals (like practicing doctors and dentists) are not immune to federal anti-trust laws unless they’re directly overseen by full-time agents of the state.
State-level regulatory news
A number of states dealt with telemedicine regulation.
The Arkansas House of Representatives voted down a bill that would allow telemedicine companies to offer services within the state. The bill was defeated 41-21 with two people voting present. The bill was sponsored by Rep. Dan Sullivan (R-Jonesboro) who explained in the hearing that the bill specifically addressed “the opportunity to do certain primary care activities, primary care diagnoses over the phone and over video”.
Shortly after the Arkansas House of Representatives rejected the bill, the House passed a more limited bill, which had already cleared the Senate, increasing the allowable range of telemedicine services. The new bill, SB133, is more restrictive than the one that was previously voted down. It allows telemedicine practitioners to be licensed as doctors in Arkansas, provided they have a pre-existing in-person relationship with their patient.
Fresh off the news of its IPO filing, Dallas, Texas-based Teladoc sued the Texas Medical Board, alleging that a recently passed rule requiring doctors to have an in-person or face-to-face visit with a patient in order to prescribe medication, is in violation of antitrust laws and has no purpose other than to muscle out telemedicine companies.
Because each state approaches telemedicine differently, the American Telemedicine Association published policy-focused reports with state-by-state analysis.
States were also occupied with digital health issues outside of telemedicine.
New Jersey’s Division of Consumer Affairs launched a new app for iPhones that will allow authorized users of the state’s prescription monitoring program, prescribers and pharmacists licensed in New Jersey, access to the database via their smartphone.
Madison, Wisconsin-based Propeller Health expanded its collaboration with the City of Louisville, Kentucky, thanks to a grant from the Robert Wood Johnson Foundation. The new program, called Air Louisville allows the city to collect data from sensors attached to 2,000 asthma inhalers, which can then be used for public health purposes.
Minnesota Department of Human Services (DHS) allocated $1 million for Minnesota-based Canvas Health’s suicide prevention texting program, called Txt4Life. The state is providing $500,000 per year for the next two years on top of $625,000 in base funding per year to expand the program statewide, National Alliance on Mental Illness of Minnesota Executive Director Sue Abderholden told MobiHealthNews in an email.
The Department of Veterans Affairs continues to develop, innovate, and scale its mobile health initiatives according to a report published in the Washington Post. The VA gave the Post some updates on its in-house mobile health projects, such as the VA’s family caregiver pilot, which has now been expanded into a full app store for veterans and their families. While the program originally included 10 apps, the store now boasts 17 health and wellness apps, although not all of those are actually mobile-enabled yet; some are still desktop apps.
According to a posting onClinicalTrials.gov, the VA is embarking on a new clinical trial of its PTSD Coach app, to test whether the app is more effective with clinician support. After a first phase of interviews with primary care and mental health practitioners, investigators will move onto a small 16-week study of 30 veterans with post-traumatic stress disorder (PTSD) who will be randomized to either clinician-supported or self-managed interaction with the app.
The VA Boston Healthcare System will launch a pilot using the Basis Peak wearable. The wristworn device will be used to evaluate the effect of a drug on veterans’ sleep habits. San Francisco-based Basis, which was acquired by Intel last year, is donating 1,000 Basis devices to the Boston VA, some of which will be used for the sleep study, and others of which will be used for the VA’s Move! weight management program.
Earlier this year, the Senate Special Committee on Aging held a hearing to learn about the potential of aging in place technologies, including sensors and wearables. Aging In Place Technology Watch lead Laurie Orlov and VA Deputy Chief Patient Care Services Officer Maureen McCarthy testified, along with academics Marjorie Skubic from the University of Missouri and Carol Kim from the University of Maine.
U.S. Department of Health and Human Services (HHS) and Health Resources and Services Administration (HRSA) commissioned a study that found Text4baby subscribers are engaged with the texting program, would recommend it to others, and have gained knowledge about critical maternal and child health topics after using it.
The Scripps Translational Science Institute (STSI) received a grant from the US Agency for International Development (USAID) to create a program that will use health sensors to improve the health outcomes of Ebola patients. The program is called STAMP2, short for Sensor Technology and Analytics to Monitor, Predict and Protect Ebola Patients.
Dallas-based accelerator Tech Wildcatters and Chicago-based accelerator TechNexus announced that they were accepting applications for a new incubator program, called Emerge. The program will accept companies that are working on wearable technology that can help first responders. The two accelerators were tapped by the US Department of Homeland Security (DHS) and the nonprofit Center for Innovative Technology (CIT).
And the White House provided more details about the new $215 million Precision Medicine program that President Obama briefly mentioned during his State of the Union address.
Overseas, NHS England and the National Information Board (NIB) announced that they will consider equipping all NHS facilities in England with free WiFi. NHS England explains that offering free WiFi in the health system’s facilities would reduce the administrative burden on doctors, nurses, and care staff. Administrative duties occupy, at most, 70 percent of a junior doctor’s day, NHS England explains.
In the first half of 2015, MobiHealthNews tracked 17 digital health FDA clearances:
San Francisco-based AliveCor received FDA clearance for two new algorithms for its smartphone-connected ECG: one that detects normality and one that detects interference. The Normal Detector assures patients that their ECG is free of abnormalities. If any abnormality is detected, it returns a result of “undetermined.” The decision to develop it was based on a poll conducted by AliveCor that found that 9 out of 10 people with heart health issues just want to know if their ECG is normal.
Rochester, Minnesota-based Mayo Clinic spin-off Ambient Clinical Analytics received FDA 510(k) clearance for a software-based decision support tool, called AWARE, which stands for Ambient Warning and Response Evaluation. It’s an interface for EMR data that prioritizes and organizes a patient’s medical information in three ways: by organ, chronologically as a timeline, or as a customized checklist that displays only the next steps relevant to that case.
Vital Art and Science, developers of myVisionTrack, a vision test service for patients with age-related macular degeneration or diabetic eye disease, received a second FDA clearance for their platform, which includes an app and a provider dashboard. They will also soon launch a major clinical trial in partnership with the Scripps Translational Science Institute and Roche.
ViSi Mobile got FDA clearance way back in 2012, but continues to get new clearances as it updates its algorithm. The latest clearance adds better posture and gait tracking — and fall detection — to the ambulatory remote patient monitoring system.
Vitaphone has been doing mobile ECG monitoring since at least 2010, using a 12-lead ECG and sending data via Bluetooth to a satellite phone to a patient’s caregiver. The new clearance is a small change from their existing, cleared device: the new version will provide three ECG recording channels rather than just one.
Medtronic received FDA 510(k) clearance for its MiniMed Connect device, which allows users of Medtronic’s continuous glucose monitor (CGM) and insulin pump to view data from those devices on their smartphone. At the same time, Medtronic announced a partnership with Samsung to optimize the viewing of this CGM and pump data.
InvisionHeart received FDA 510(k) clearance for a mobile 12-lead ECG that can be accessed via a secure, browser-based online system. The company believes having the data in the cloud will make it easier for providers to access the data more quickly, leading to more timely interventions for heart patients.
Los Altos, California-based Gauss Surgical received an FDA 510(k) clearance for its Triton iPad app, which can now estimate the surgical blood loss in canisters that hold blood.
Israel-based Voyant Health, a subsidiary of Germany-based medical technology company Brainlab, received FDA clearance for its iPad app, called TraumaCad Mobile, which helps orthopedic surgeons with their pre-operative surgical planning.
An oral appliance for treating sleep apnea, with an embedded wireless compliance sensor, received FDA clearance. The device is from Australian company SomnoMed and the tracker is from Braebon Medical Corporation, a company based in Ontario, Canada.
ToSense, formerly known as Perminova, received FDA 510(k) clearance for its device, which is intended to be worn for a few minutes a day by patients managing their care at home. The startup lists Scripps Health cardiologist Eric Topol as an advisor.
New York City-based Cohero Health received FDA 510(k) clearance for its mobile connected spirometer. The Bluetooth-connected device measures critical lung function with comparable accuracy to clinical-grade spirometers, and sends the data to a smartphone or tablet.
Roche received FDA clearance for its Accu-Chek Connect companion app, and, less than a month later, issued a recall of that app.
Dexcom received clearance from the FDA for a new version of its smartphone connected Dexcom Share platform that will eliminate the docking cradle and allow a patient’s continuous glucose monitor data to be transferred directly to a user’s smartphone, as well as the smartphones of up to five friends or caretakers.
Sense4Baby, the maternal and fetal monitoring product developed by West Health and then acquired by AirStrip Technologies, received a second FDA 510(k) clearance, which will allow pregnant mothers to perform non-stress tests in their homes. The technology was previously only cleared for use by providers in clinical settings.
An FDA-cleared clinical grade activity tracking system came to the US for use in workplace injury prevention. The ViSafe system, from Australian company dorsaVi, was previously deployed in Australia and the UK in fields ranging from retail to mining.
Australia-based Analytica received FDA 510(k) clearance for PeriCoach, its smartphone-connected device that helps women monitor their pelvic floor exercises. The goal of PeriCoach is to reduce or stop urinary incontinence. It will commercially launch in the US next week.
Jintronix secured FDA 510(k) clearance for a product that offers providers specially designed, clinically tested video games that both allow patients to exercise and collect data about their exercises to send to an online portal.
Digital health M&A from the first half of 2015
So far, 2015 hasn't been the banner year for acquisitions that 2014 was -- by the halfway point last year, there had already been 18, three more than there have been this year. By the end of 2014 there were 33. Yet, many of the acquisitions this year have been high-impact ones, starting with Under Armour's $560 million deal to acquire MyFitnessPal and Endomondo. Here are the 15 deals we've tracked since the start of the year.
Under Armour buys MyFitnessPal and Endomondo
In February, Baltimore, Maryland-based athletics apparel company Under Armour acquired two health and fitness app makers: San Francisco-based fitness platform MyFitnessPal and Denmark-based Endomondo. Endomondo, which makes free GPS-based tracking apps, went for for $85 million and MyFitnessPal, which offers apps that track fitness and diet, was acquired for $475 million. Under Armour CEO Kevin Plank was very straightforward about the reasons for the acquisition, saying that the company was building a comprehensive fitness trackign platform with the goal of selling more apparel.
"At the end of the day, the math is pretty simple,” he said in an investor call. “The more active someone is, the more likely they are to buy athletic apparel and footwear. And for the month of January, the four sites in our Connected Fitness platform, MapMyFitness, Endomondo, MyFitnessPal and UA Record, recorded more than 100 million workouts and added 4.2 million new unique users."
Daqri buys Melon
Melon, the EEG-tracking headband company that raised nearly triple its initial goal in a 2013 crowdfunding campaign, was acquired in February by Daqri, an enterprise augmented reality company founded in 2010, for an undisclosed amount.
Daqri’s CEO Brian Mullins announced the acquisition from the keynote stage at the 4D Expo, an event hosted by the company. Daqri is working on something it calls “4D,” a catch-all term for technology that displays data directly in the user’s environment somehow rather than confining it to a screen. One facet of that work is a Smart Helmet the company is developing, and Melon’s technology will be incorporated into that helmet.
Sharecare buys Feingold Technologies
Also in February, Atlanta-based Sharecare, the health and wellness engagement platform founded by WebMD founder Jeff Arnold and television personality Dr. Mehmet Oz, acquired Germany-based Feingold Technologies, a company that offers software that analyzes human behaviors. As part of the acquisition, Feingold Technologies offices, in Berlin and Munich, will operate under Sharecare, effective immediately, the company said. Feingold’s team will work with Sharecare’s existing product and technology teams to create mobile products and apps that help people optimize their productivity. The first such offering of the acquisition has already launched in a closed beta for Android devices.
Fitbit buys FitStar
In March, activity tracker startup Fitbit acquired fitness coaching app developer, FitStar, for at least $17.8 million -- and likely more, with some publications putting the deal between $25 million and $40 million in a mix of cash and stock. Prior to the acquisition, Fitbit already offered a premium $49.99 a year service that includes personalized fitness plans and goals generated after an analysis of the user’s Fitbit data, more in-depth data reports, and comparison tools that compare the user to other Fitbit users. The FitStar acquisition will help Fitbit build out its premium subscription features even more.
Kareo buys DoctorBase
Irvine, California-based practice management software company Kareo acquired San Francisco-based DoctorBase, maker of a mobile-based patient communications offering, in March. While DoctorBase’s offerings are still available on their own for now, Kareo plans to combine DoctorBase’s offering with its practice management service too. The companies said they will slowly integrate their products into a single offering. They aim to launch a “limited availability, lightly integrated release” in early Q2 and a deeper integration in the second half of the year.
Weight Watchers buys Weilos and Hot5
In April Weight Watchers acquired Weilos, which offers users a picture taking app to document weight loss through selfies -- creating some possible confusion with Weight Watchers' other acquisition from last year, Wello.
Weight Watchers reportedly bought Weilos for a price in the “single-digit millions” in order to “accelerate the product and technology development of the social networking and community capabilities that Weight Watchers members are looking for”.
In May, Weight Watchers made another acquisition, buying San Francisco-based fitness app developer Hot5 for an undisclosed amount. Hot5 was established in October 2012 and launched August 2013. The startup has developed two video workout apps, Hot5 Fitness and Vertical Escape Fitness Challenge, which are available for iOS devices. Both apps are free to download and offer a handful of workouts, but users need to sign up for a paid subscription for more.
Clinical Ink merges with Centros Health
In March, pharma-focused mobile clinical trial data collection company Clinical Ink merged with CentrosHealth, formerly MyHealthBook, which makes configurable mobile apps for clinical trial patient engagement. As part of the deal, MPM Capital, which founded CentrosHealth, made an additional investment in Clinical Ink, as did F2 Ventures, FCA Venture Partners and other existing Clinical Ink investors.
The combination of provider and patient-facing data collection tools rounds out Clinical Ink’s approach at a time when Apple ResearchKit is shining a spotlight on the potential for mobile health in research settings.
Evidation Health merges with The Activity Exchange
In March, GE Ventures and Stanford Health Care teamed up to create Evidation Health, a company focused on evaluating the efficacy of digital health technologies. Soon after Evidation was formed it merged with wellness engagement platform company The Activity Exchange.
The Activity Exchange was a platform that aggregated data from a wide range of health and fitness apps and devices. The company aimed to help insurance companies, pharma companies and others build better engagement with their patients or members. Evidation plans to continue to work with The Activity Exchange’s past customers and academic partners, which include: Humana, Biogen, Sanofi, Harvard Business School and Wharton.
Xplore buys Motion Computing
In April, Austin, Texas-based rugged tablet maker Xplore bought longtime competitor and Austin neighbor Motion Computing. Xplore bought Motion’s assets for $9 million cash, plus the assumption of $7 million in net liabilities, after Square 1 Bank foreclosed on most of Motion’s assets. While Xplore has traditionally focused on fully ruggedized tablets for industries like energy, military operations, manufacturing, distribution, public services, public safety and government, Motion’s focus is on semi-rugged tablets for field service, healthcare, utilities, construction, retail, public safety and first responders. So the acquisition effectively brings Xplore into the healthcare space.
IBM buys Explorys and Phytel
IBM announced several pieces of news at once when it launched its new Watson Health business unit in April, including two acquisitions. The company picked up Cleveland-based Explorys and Dallas-based Phytel. The two acquisitions are both big data analytics companies. Explorys is a Cleveland Clinic spin-off that uses cloud computing to detect patterns in diseases and treatments. Phytel develops cloud-based tools to enhance care coordination and outcomes. Terms were not disclosed for either deal.
Welltok buys Predilytics
In May, Denver-based Welltok, the health management company that makes the CafeWell Health Optimization Platform, acquired Predilytics, a Burlington, Massachusetts-based predictive analytics company, for an undisclosed amount. Welltok will incorporate Predilytics’ engine into CafeWell, to help health plans, at-risk providers and other population health managers better understand and anticipate the needs of their patient populations.
Teladoc buys StatDoctors
Just a couple months after Teladoc filed for an IPO, the company disclosed that it had acquired Scottsdale, Arizona-based Stat Health Services, which offers the online doctor visit service Stat Doctors, presumably to bolster its own telemedicine offering. In a revised S-1 filing, the company disclosed that they bought Stat Health Services for for $30.5 million, comprised of $13.7 million of cash and $16.8 million of stock.
Funding for digital health companies in H1 2015
Based on the private digital health companies MobiHealthNews tracks, and excluding undisclosed amounts in known funding rounds, digital health startups have raised more than $1 billion in the first two quarters of 2015 spread across 107 deals. Some of the larger rounds included Virgin Pulse's $92 million, Advance Health's $40 million, Collective Health's $38 million, and Scanadu's $35 million.
Two well-known digital health companies filed for an IPO this year, too:
Fitbit debuted its initial public offering on the New York Stock Exchange after increasing the price of its shares to $20 apiece: The IPO raised $732 million, making it the biggest consumer electronics IPO in history, according to Dealogica. The stock began trading on the NYSE above $30 a share.
Dallas, Texas-based video visits company Teladoc filed plans for an IPO in April. A few months later the company updated its IPO filing, which now discloses that the company plans to raise $119 million in its IPO, if it is priced at the high end of its range. Teladoc will price its shares between $15 and $17. Its underwriters could raise up to an additional nearly $18 million, making for an IPO valued at as much as $136.9 million.
Here are funding rounds for digital health companies MobiHealthNews has tracked so far this year:
Virgin Pulse raises $92 million: One of the longest-running employee wellness platform companies, Virgin Pulse, announced its first outside investment, $92 million led by venture capital firm Insight Venture Partners with participation from existing investor, Virgin Group. More
Doctor On Demand raises $50 million: San Francisco-based video visits company Doctor On Demand raised $50 million in a round led by Tenaya Capital with participation from new investors Qualcomm Ventures, Dignity Health, and 23andMe CEO Anne Wojcicki. Existing investors, Venrock, Shasta Ventures, and Sir Richard Branson also contributed. More
MDLive raises $50 million: Sunrise, Florida-based MDLive, which offers telehealth services including patient-to-physician remote visits via mobile devices, raised $50 million from Bedford Funding. More
PillPack raises $50 million: Manchester, New Hampshire-based virtual pharmacy PillPack raised $50 million in a round led by CRV with participation from Accel Partners, Atlas Venture, Menlo Ventures, and SherpaVentures. More
Advance Health raises $40 million: Advance Health, a Chantilly, Virginia-based company that makes mobile patient data capture software for managed care providers, raised $40 million in a round led by Summit Partners. Noro-Moseley Partners also contributed to the round. More
Collective Health raises $38 million: San Mateo, California-based Collective Health raised $38 million in a round led by Founders Fund and NEA, with participation from Formation 8, Redpoint Ventures, RRE Ventures, Subtraction Capital, and Rock Health. Collective Health has developed a software as a service offering that helps companies that have 100 or more employees transition to a self funded insurance plan, which employers can customize to fit their needs. More
Scanadu raises $35 million: Scanadu raised $35 million from Fosun International and Tencent Holdings Limited, with participation from China Broadband Capital and iGlobe Partners of Singapore. The Moffet’s Field, California-based company is designing a multi-function home health device called the Scanadu Scout. More
Aledade raises $30 million: Bethesda, Maryland-based, tech-enabled accountable care company, Aledade, raised $30 million in venture funding led by return backer Arch Venture Partners with participation from its other existing investor Venrock. More
Iora Health raises $28 million: Cambridge, Massachusetts-based healthcare provider Iora Health raised $28 million from Foundation Medical Partners, Rice Management Company, GE Ventures, and Khosla Ventures as well as existing investors .406 Ventures, Fidelity Biosciences, and Polaris Partners. Iora currently manages 11 primary care practices in six states. More
Sharecare raises $25 million: Atlanta-based Sharecare, the health and wellness engagement platform founded by WebMD founder Jeff Arnold and television personality Dr. Mehmet Oz, raised $20 million from Wellington Management Company. Additionally, Sharecare picked up a $5 million investment from Trinity Health (formerly CHE Trinity), a healthcare system that has been investing in Sharecare since 2013. The two investments bring the company’s total funding to $160 million. More
Welltok raised $21 million: Denver, Colorado-based Welltok, the health management company that makes the CafeWell Health Optimization Platform, raised $21.3 million in a mix of equity and security, according to an SEC filing. More
Novu raises $20 million: Minneapolis-based Novu raised $20 million from SSM Partners and Noro-Moseley Partners for its app-enabled wellness program, which it offers to payors, providers, and employers. More
Livongo raises $20 million: Livongo Health, the diabetes management company launched last fall by former Allscripts CEO Glen Tullman, raised $20 million in second-round funding. Kleiner Perkins Caufield & Byers (KPCB) and DFJ Venture contributed to the round, as did previous investor General Catalyst Partners. More
EarlySense raises $20 million: EarlySense, an Israeli company which makes a passive and contactless bedside monitor that continuously measures respiration rate, heart rate, and motion, raised $20 million, with $10 million constituting a strategic investment from Samsung. Welch Allyn, which licenses EarlySense’s sensor, also contributed, as did other existing investors Pitango Venture Capital, JK&B, Proseed and Noaber. More
Ginger.io raises $20 million: San Francisco-based health behavior monitoring and analytics startup Ginger.io raised $20 million. This brings the company’s total funding to at least $28.2 million. It’s likely that Kaiser Permanente Ventures invested in the round because Ginger.io added Kaiser Permanente Ventures partner Dave Schulte to its board in the filing. Existing investors include Khosla Ventures, True Ventures, and Romulus Capital. More
Glooko raises $16.5 million: Diabetes management platform Glooko raised $16.5 million in a round led by Canaan Partners. The round also included a strategic investment from Medtronic as well as funding from additional investors, The Social+Capital Partnership and Samsung. More
Augmedix raises $16 million: San Francisco-based Augmedix, which has developed a Google Glass clinical documentation offering for physicians, raised $16 million in a round co-led by existing investors Emergence Capital and DCM Ventures. Augmedix received $23 million in venture funding to date. The company plans to use some of the funding to create new partnership initiatives. More
Spruce raises $15 million: San Francisco-based direct-to-consumer remote dermatology care service Spruce raised $15 million from Kleiner, Perkins, Caufield and Byers, Google Ventures, Baseline Ventures, and Cowboy Ventures. This brings the company’s total funding to $17 million to date. Spruce offers consumers an app that helps them get treatment for some skin problems without having to interact with a physician in-person or even in real-time. More
Crossover Health raises $15 million: Aliso Viejo, California-based healthcare provider Crossover Health raised $15 million from Norwest Venture Partners (NVP) to enhance its patient-facing tools, which includes an iPhone app, and create a population health analytics offering. Crossover focuses on providing on-site care to large employers. More
Noom raises $15 million: Wellness app maker Noom raised $15 million. Han-Sing Hi-Tech Fund as well as existing investors TransLink Capital and RRE Ventures contributed to the round. This brings the company’s total funding to at least $24.6 million. The funding, according to the SEC filing, “will be used for research and development, general corporate and working capital purposes, some of which may include salaries and/or other compensation paid to executive officers in the ordinary course of business”. More
Carena raises $13.3 million: Seattle-based Carena, which offers a video visit service for health systems, raised $13.3 million from Cambia Health Solutions, McKesson Ventures, Catholic Health Initiatives (CHI), and Martin Ventures. More
Cureatr raises $13 million: New York-based Cureatr, which has developed a mobile care coordination offering, raised $13 million in a round led by Deerfield Investments with participation from Cerner Capital and Windham Ventures as well as existing investors Cardinal Partners, Milestone Venture Partners, Partnership Fund for New York City, and JMI Services. More
AbilTo raises $12 million: New York-based behavioral health startup AbilTo raised $12 million in third round funding led by HLM Venture Partners. Existing investors BlueCross BlueShield Venture Partners, .406 Ventures and Sandbox Industries all contributed to the round as well. More
MDsave raises $12 million: Brentwood, Tennessee-based MDsave raised $12 million for its medical procedure payment service from MTS Health Investors, a New York-based private equity firm. This brings the company’s total funding to at least $19 million. More
Validic raises $12.5 million: Durham, North Carolina-based health data platform company Validic raised $12.5 million in a round led by Kaiser Permanente Ventures. Last year the company closed out its $5 million first round, and in 2013 it raised a seed round that included investment from Mark Cuban. This latest round brings the company’s total funding to at least $18.5 million. More
Welltok raises $12 million: Denver, Colorado-based Welltok raised $12 million co-led by Hearst Ventures and Catholic Health Initiatives. The capital tops off a $37 million round for the company, which disclosed the other $25 million in October. Welltok’s funding for the past year has reached $59 million — the company’s total disclosed funding now stands at around $72.7 million. More
goBalto raises $12 million: Software company goBalto raised $12 million for its software-as-a-service clinical research platform. This brings the company’s total funding to at least $30 million to date. Existing goBalto investors include Aberdare, West Health, EDBI, and Qualcomm Health. GoBalto’s main product, Activate (formerly Tracker 2.0), offers clinicians a clinical research platform for “study startup”, which is the process of collecting, reviewing, and approving hundreds or thousands of clinical documents needed in a clinical trial. More
SOLS raises $11.1 million: New York City-based SOLS, maker of 3D printed insoles, raised $11.1 million from Tenaya Capital and Melo7 Tech Partners as well as existing investors Founders Fund and Lux Capital. This brings the company’s total funding to date to $19.3 million since SOLS launched in July 2013. More
InteraXon raises $11 million: Toronto-based InteraXon raised $11 million for its smartphone-connected brainwave sensing device, called Muse. InteraXon previously raised $7.2 million in two rounds from Horizon, OMERS Ventures, A-Grade, which is Ashton Kutcher’s fund, Felicis Ventures, and ff Venture Capital. TechCrunch reported that, in February 2014, Google had approached InteraXon about an acquisition, but InteraXon wasn’t interested. More
Pager raised $10.4 million: Pager, which offers an app consumers can use to request in-person physician house calls, raised $10.4 million. The round was put up by existing seed investors Lux Capital and Montage Ventures, and new investors Goodwater Capital and Summation Health Ventures. New York City-based Pager, which launched last May, is one of many startups to have called itself an “Uber for doctors”, but it may have a greater claim to that label than others: One of the company’s founders, Oscar Salazar, was also on Uber’s founding team. More
Sano raises $10 million: San Francisco-based Sano Intelligence, which is quietly developing a health-sensing wearable, raised $10.25 million in funding from True Ventures and Intel Capital with participation from First Round, Felicis Ventures, Elevation Capital, Floodgate, and Rock Health. More
DocPlanner raises $10 million: Warsaw, Poland-based DocPlanner, which offers a service that helps consumers find and book appointments with providers, raised $10 million in a round led by the European Bank for Reconstruction and Development and angel investor Lukasz Gadowski. This brings the company’s total funding to $14 million. More
Voalte raises $10 million: Sarasota, Florida-based Voalte, which offers a suite of smartphone-based communication tools to nurses and other hospital caregivers, raised $10 million. This brings the company’s total funding to at least $52 million. Voalte’s mobile communication tools help healthcare providers connect with one another when they are inside the hospital, but they can also help connect providers to other members of a patient’s care team outside the hospital. More
SwipeSense raises $9.6 million: Smart hand hygiene sensor-maker SwipeSense, based in Evanston, Illinois, raised $9.6 million. Previous investors in the company include Jumpstart Ventures and Healthbox, which counts SwipeSense among the graduates of its very first class back in 2011. More
Talkspace raises $9.5 million: New York City-based startup Talkspace, which offers therapy sessions via the web and mobile devices, raised $9.5 million in a round led by Spark Capital, with participation from SoftBank. Existing investors Metamorphic Ventures and TheTime also participated. This brings the company’s total funding to at least $13 million. More
MyTime raises $9 million: San Francisco-based general appointment booking service MyTime raised $9.25 million in a round led by existing investor, Upfront Ventures, with participation from new investors Khosla Ventures, Daher Capital, Accelerator Ventures, and Westfield Corporation. While MyTime is not helping patients book appointments with primary care physicians, it helps users book appointments for a number of health-related services. More
meQuilibrium raises $9 million: Boston-based meQuilibrium, which has developed a mobile stress management program, raised $9 million in a funding round led by Safeguard Scientifics with participation from Chrysalis Ventures. Employers can provide this service to their employees so that employees can manage stress and boost positivity in the workplace. More
Atheer Labs raises $8.8 million: Mountain View, California-based Atheer Labs, maker of an augmented reality headset that it is working to get into the hands of clinicians (among others), raised $8.8 million in equity, options, and securities. Streamlined Ventures Founder Ullas Naik was listed on the SEC filing, though he is not listed on Atheer Labs’ board or among its advisors. This suggests Streamlined Ventures may have invested in this round. More
DigiSight raises $7.8: DigiSight Technologies, a California-based company currently focused on mobile apps for ophthalmology, raised $7.8 million in second round financing. The round was led by Biosys Capital, Waycross Ventures, GE Ventures, and Lagunita, with additional contributions from existing investors. More
SocialWellth raises $7.5: Las Vegas-based SocialWellth, maker of white label digital health and wellness offerings for payers, providers, and employers, raised $7.5 million. This brings the company’s total funding to at least $12 million to date. More
Peak raises $7 million: London-based Peak raised $7 million for its brain training app, in a round led by Creandum with participation from DN Capital, London Venture Partners, and Qualcomm Ventures. The app, available on iOS and Android devices, aims to help users improve their memory, focus, problem solving, mental agility, and language skills. More
Human API raises $6.6 million: Palo Alto, California-based Human API raised $6.6 million from 16 investors, according to an SEC filing. Human API offers providers an infrastructure they can use to create a health platform that enables a group of patients to share data with their caregivers. More
Smart Vision Labs raises $6.1 million: New York City-based Smart Vision Labs, which has developed a smartphone-based autorefractor for vision testing, raised $6.1 million in a round led by Techstars Ventures with participation from Heritage Group, Connectivity Capital, and Red Sea Ventures. More
MediSafe raises $6 million: Medication adherence app company MediSafe raised $6 million in a round led by Pitango Venture Capital with participation from 7wire Ventures as well as existing investors lool Ventures, TriVentures, and Eyal Gura. This brings the company’s total funding to at least $7 million to date. The company also received $2.36 million in prize money from Seven Ventures (7VPD) last month. More
Trialbee raises $5 million: Swedish clinical trial recruitment company Trialbee raised $5 million in first-round funding from existing investors Industrifonden and Briban Invest. The company previously raised about $3.2 million in seed funding. More
Heal raises $5 million: Los Angeles-based Heal, which has developed an app that helps people request a doctor to visit their house, raised $5 million from Slow Ventures, March Capital, Pritzker Capital, and angel investors. More
Modernizing Medicine raises $5 million: Modernizing Medicine secured a $5 million investment, completing the $20 million funding round the company began last November. One of the investors in the round was IBM, through its $100 million fund to seed Watson innovations. More
Fitmob raises $5 million: San Francisco-based fitness app company fitmob raised $5 million from 112 investors — $1 million of the funding came from Recruit Strategic Partners and was previously disclosed. Some $3.25 million of the round came from Mayfield Fund, Structure.vc, Venture51, Queensbridge Capital, and Vast Ventures. This brings the company’s total funding to at least $14.8 million. More
mySugr raises $4.8 million: Austria-based diabetes app company mySugr raised $4.8 million from Roche Ventures and iSeed Ventures. Existing investor XLHealth also contributed to the round, which will help mySugr scale up its user base in the US and other other countries. More
Sproutling raises $4 million: San Francisco-based Sproutling raised $3.9 million. The company started the round in August 2013 and has raised at least $6.5 million total to date. Sproutling has developed a health sensing device that a baby wears around their ankle. The device measures heart rate, skin temperature, motion, and the baby’s position. More
Caremerge raises $4 million: Caremerge, makers of a care coordination software for seniors in assisted living facilities, raised $4 million in its first institutional round of funding. Cambia Health Solutions led the round. Generator Ventures, GE Ventures, Arsenal Venture Partners, and the Ziegler-LinkAge Longevity Fund also contributed. More
Heal raises $3.7 million: Los Angeles-based Heal, which has developed an app that helps people send a doctor to their house, raised $3.7 million in seed money from Lionel Richie, Qualcomm Executive Chairman Paul Jacobs, and Dodgers co-owner Jamie McCourt. More
BaseHealth raises $3.6 million: Health data platform company BaseHealth raised $3.6 million. The company has developed a health assessment service, called Genophen, that payors and providers can offer to members and patients. More
Ovuline raises $3.2 million: Boston-based women’s health app developer Ovuline raised $3.2 million from Martin Ventures and Zaffre Investments, the investment arm of Blue Cross Blue Shield of Massachusetts. About $1 million of this investment came from Zaffre Investments. More
Lyra Health raises $3.1 million: Burlingame, California-based Lyra Health, which is developing a platform to identify people with behavioral health conditions, raised $3.1 million in a strategic round from Castlight Health. More
Monica Healthcare raises $3 million: UK-based fetal monitor maker Monica Healthcare raised $3 million (2 million British pounds) from existing investors Catapult Ventures, the New Hill Growth Fund, East Midlands Business Angels, the University of Nottingham as well as new investors Wren Capital, Origin Capital, Catamaran Ventures, and the London Business Angels. This brings the company’s total funding to at least $4.6 million. More
ePatientFinder raises $2.6 million: Austin, Texas-based clinical trial recruitment company ePatientFinder raised nearly $2.6 million from Parsons & Whittemore and a group of angel investors. This brings the company’s total funding to about $4 million. The company closed a $1.4 million round in May 2014, according to Austin Business Journal. More
Ayogo raises $2.5 million: Vancouver-based Ayogo raised $2.5 million from Merck Global Health Innovation Fund (GHI), Excel Venture Management, and 7Wire Ventures for it’s patient engagement offering, an app called Empower. More
Conversa raises $2.5 million: San Francisco-based Conversa Health, which makes a digital patient engagement platform, raised $2.5 million from undisclosed healthcare-focused angel investors. The company also announced the appointment of a new chief technology officer and the formation of its medical advisory board. More
Klara raises $2.5 million: Berlin-based Klara raised $2.5 million from Partech Ventures; Creathor Venture; Stephan Schambach, founder of ecommerce service Demandware; and Heilemann Ventures. Klara has developed an app, available on iOS and Android devices, that helps dermatologists communicate with their patients. More
Skipta raises $2.5 million: Lancaster, Pennsylvania-based Skipta, which oversees social media communities for medical specialties, raised $2.5 million in its first round of funding, which was led by Mansa Capital. More
Smartlink Mobile Systems raises $2.5 million: Smartlink Mobile Systems raised $2.5 million from a single undisclosed strategic corporate investor and various healthcare professional angels, including about a half dozen physicians. The new round of funding will help Smartlink launch its patient engagement app, called Pocket HealthNet, which helps physicians take advantage of a new CMS rule that pays for certain asynchronous telehealth services. More
SoloHealth, now Pursuant Health, raises $2.4 million: Health kiosk company SoloHealth has changed its name to Pursuant Health and raised $2.4 million in equity and securities, according to an SEC filing. Per the company’s website, the name change reflects a new partnership with Cleveland Clinic Wellness, which the company embarked on at the end of March. This will add a workplace wellness business to the company’s existing public kiosk business. More
Wellbe raises $2.4 million: Madison, Wisconsin-based Wellbe raised $2.4 million for its web-based patient coordination software Guided CarePath from former Pharmacy OneSource CEO Terrence Gibbons, former Baxa CEO Greg Baldwin, former Nordic Consulting CEO Mark Bakken, and Medcor CEO Philip Seeger. More
Eligible raises $2.3 million: Eligible, which offers an API that other health tech companies use to add a streamlined insurance eligibility check feature for doctors and patients, raised $2.3 million. More
Sherpaa raises $2.25 million: New York City-based digital healthcare service Sherpaa raised an additional $2.25 million. The funding is an amendment to last year’s $4 million round. This brings the company’s total funding to at least $8 million. More
Sense.ly raises $2.2 million: Sense.ly, a San Francisco-based “virtual nurse” company that spun out of mobile operator Orange in 2013, raised $2.2 million. New investors in the round include Fenox Venture Capital and TA Ventures. More
Joyable raises $2 million: San Francisco-based Joyable raised $2 million from Thrive Capital, Harrison Metal, and angel investors including Benchmark Capital co-founder Andy Rachleff. Joyable has developed an online program, based on cognitive behavioral therapy (CBT), that aims to help consumers improve their social anxiety. More
Clue raises $2 million: Germany-based Clue raised $2 million from German private investor Brigitte Mohn; French Groupe Arnault, the controlling shareholder of LVMH (Moët Hennessy – Louis Vuitton); the German pharmaceutical company DR. KADE; as well as executives from Spotify, Dropbox, and SoundCloud. This brings the company’s total funding to $3 million. More
Eko Devices raises $2 million: Berkeley, California-based smartphone-enabled stethoscope company Eko Devices raised $2 million in a round led by existing investor Founder.org with participation from Stanford StartX, and angels, including former HHS advisor John Noonan and the cofounders of music identification company Shazam. This brings the company’s total funding to date to $2.8 million. More
ChartSpan raises $1.7 million: Greenville, South Carolina-based ChartSpan raised $1.7 million in a round led by existing investor, Byrne Medical’s Don Byrne. This brings the company’s total funding to just under $3 million. More
Force Therapeutics raises $1.7 million: New York City-based Force Therapeutics raised $1.7 million in a round that the company started September 2013. This brings the company’s total funding to date to $2.2 million. Existing investors include former OpenTable CEO Thomas Layton; former CEO of Revolution Health and TicketMaster, John Pleasants; and FiveW Capital Managing Member Randall Winn. More
Kura MD raises $1.5 million: Roseville, California-based telehealth company Kura MD raised $1.5 million in a round led by Moneta Ventures. The company’s team includes telemedicine pioneer Dr. Jay Sanders as director of telemedicine strategy. This is its first round of institutional funding. More
Hello Heart raises $1.3 million: Redwood, California-based health app maker Hello Heart raised $1.3 million in a round led by Resolute Ventures with participation from angel investors including Waze CEO Noam Bardin, BlueRun ventures Co-founder John Malloy, and Facebook Product Director Ran Makavy. More
Iagnosis raises $1.2 million: Iagnosis, parent company of virtual visit skin care company DermatologistOnCall, raised $1.2 million. This brings Iagnosis’ total funding to date to $10 million. The company had raised $2.8 million in May 2014. More
Pacify raises $1.1 million: Earlier this month Washington DC-based telehealth startup, Pacify, raised $1.1 million from local accelerator Acceleprise and a dozen angel investors. The startup is initially focused on pediatrics and connecting new parents with lactation consultants, nurses, and dietitians via video visits through a mobile app. More
iGetBetter raises $1.1 million: iGetBetter, a Sudbury, Massachusetts-based company that aims to reduce hospital readmissions through remote patient monitoring and post-discharge patient engagement, raised $1.1 million from undisclosed private investors. More
CarePredict raises $1 million: Plantation, Florida-based CarePredict raised $1 million for an aging in place technology service that helps caregivers keep tabs on the wellbeing of older family members. More
CareLinx raises another $1 million: San Bruno, California-based CareLinx, which offers a service to connect seniors with caregivers, raised $1 million from Generator Ventures and Ziegler Link-age Longevity Funds. This brings the company’s total funding to at least $5.2 million. An SEC filing explains that this amount includes $2.1 million in forgiveness of debt. More
Noom raises $1 million: New York-based wellness app maker Noom raised $1.1 million to complete a $16.1 million round led by InterVest, a Korea-based venture capital firm, with participation from LB Investment, Hanmi IT (a subsidiary of Hanmi Pharmaceutical), RRE Ventures, TransLink Capital, and Qualcomm Ventures. More
Gozio Health raises $1 million: Last week Atlanta-based Gozio Health, which offers a patient-facing indoor wayfinding app to hospitals, raised just under $1 million in funding from a handful of angel investors, including an undisclosed “large family office”, an unnamed Palo Alto-area investor, and Atlanta-based investor Rutherford Seydel. More
VitalMedicals raises $1 million: Stanford spinoff VitalMedicals raised $925,000 to continue developing Google Glass software that helps surgeons be continuously aware of patients’ vital signs while doing surgery. The company is closing a final investor that will bring the round up to $1.1 million, CEO Ash Eldritch told MobiHealthNews in an email. The round was led by a professional angel syndicate led by Mark Lefanowicz, with additional contributions from the Stanford StartX accelerator. More
Lift Digital raises $1 million: Montreal-based Lift Digital, which offers a live, online video-based fitness training program, raised $1 million in seed funding led by 24 Hour Fitness co-founder Leonard Schlemm. Last year Lift’s program, called Lift Session was piloted by a number of fitness clubs in major US and Canadian cities, according to the company. More
Health Recovery Solutions raises $1 million: New York City-based Health Recovery Solutions raised $1 million from undisclosed investors, the company’s COO Rohan Udeshi told MobiHealthNews. This brings the company’s total funding to $1.8 million. More
Talkspace raises $1 million: New York City-based startup Talkspace, which offers therapy sessions via the web and mobile devices, raised $1 million in seed funding from Metamorphic Ventures. This brings the company’s total funding to at least $3.5 million. More
Conceivable raises $800,000: Austin, Texas-based Conceivable raised $800,000 from angel investors for its fertility app, which is designed to help women who are having trouble conceiving a child and staying pregnant. More
Elli Health raises $774,000: Delafield, Wisconsin-based Elli Health raised $774,000 in a mix of equity and options for its virtual visits offering. This brings the company’s funding to at least $900,000 to date. More
myHealthPal raises $700,000: New York City and London-based myHealthPal, not to be confused with telehealth product HealthPAL, data platform MyFitnessPal, or Advocate Children’s Hospital’s app MyHealth Pal, raised $744,000 (500,000 pounds) in a round led by Andrew MacKay (chairman of Yapp Brothers) and angel investor Will Armitage with participation from Proxy Ventures. More
Orb Health raises $650,000: Phoenix, Arizona-based Orb Health raised $650,000 from incubator Health Wildcatters, Green Park and Golf Ventures, and others. Orb Health has developed a platform that helps patients and providers access a patient’s lab data and wearable device health data. More
Medocity raises $650,000: Morristown, New Jersey-based Medocityraised $650,000. This brings the company’s total funding to at least $3 million. The company offers providers a handful of care coordination and patient engagement programs focused on cancer care, congestive heart failure, and senior care. More
Chrono Therapeutics raises $100,000: Chrono Therapeutics, a Hayward, California-based company working on a new wearable for smoking cessation and drug delivery, received an investment from seed fund Rock Health. Rock Health contributed $100,000. This brings the company’s total funding to about $32.1 million. More
StartUp Health gets strategic investment from Wisconsin health system: New York-based digital health accelerator, network, and innovation fund StartUp Health received a strategic investment from Wisconsin health system Aurora Health Care. The terms of the investment are undisclosed, but the companies described Aurora in a statement as “taking a lead investor role” in the company.
Teva Pharmaceuticals invested tens of millions in American Well: American Well secured an eight-figure investment from Israeli pharmaceutical giant Teva, according to a recent report in Israeli publication Globes. The investment of “tens of millions of dollars” is part of a new push into digital health by Teva, which has also included the development of a cellular-connected smart inhaler, an app for reporting negative drug interactions, and a “digital support center for multiple sclerosis patients”, as well as an incubator launched in Israel in collaboration with Phillips. More
Center for Innovative Technology GAP Fund invests in Ostendio: DC-based Ostendio, which developed a software-as-a-service offering aimed at helping health IT companies better achieve and prove HIPAA compliance, received an undisclosed investment from CIT Gap Fund. CIT GAP Fund, a group of seed and early-stage investment funds, invests in Virginia-based technology, life science, and cleantech startups. More
Pear Therapeutics raises money for drug-software combo products: Pear Therapeutics, not to be confused with Pear Sports, raised an undisclosed sum in a round led by 5AM Ventures. The company has developed a product called eFormulations that combines medication for a specific condition with a digital therapy program. The eFormulations product will be prescribed by physicians to their patients. More
Thiel Foundation’s Breakout Labs invests in Neumitra: Boston-based Neumitra, which has developed a wearable that continuously measures the autonomic nervous system to track stress levels, received an undisclosed amount of seed funding from the Thiel Foundation’s Breakout Labs. Breakout Labs typically invests between $100,000 and $350,000 in its portfolio companies. More
HCA invests in Sharecare: HCA made an undisclosed investment in Sharecare, the health and wellness engagement platform founded by WebMD founder Jeff Arnold and television personality Dr. Mehmet Oz, and the companies are creating a joint innovation lab together. More
Fairview Health invests in Zipnosis: Minneapolis, Minnesota-based telemedicine company Zipnosis received a “significant” strategic investment from Fairview Health, the hospital system the company has been working with the past several years. More
Digital health industry metrics from H1 2015
During the first half of 2015, research groups published metrics and surveyed a variety stakeholders in the healthcare industry about digital health.
Surveys, polls and other provider-focused digital health metrics
Spyglass Consulting found that physician adoption of smartphones and tablets is higher than it’s ever been, but poor communication between IT departments and doctors keeps those devices from being effectively used. The report estimates that 96 percent of doctors have smartphones, but only 10 percent are actually willing to use their mobile devices to access electronic health records. Spyglass spoke to 100 tech-savvy doctors for the report.
While iOS devices still dominate, these days healthcare professionals may be more likely than other professionals to be Android, according to a report from Citrix. In the Americas, average Android adoption across all enterprises — not just healthcare — is currently at about 26 percent. Healthcare professionals are still mostly iOS users — 55 percent have some kind of Apple device. About 2 percent of healthcare professionals are Windows device users and the remaining 4 percent use other devices.
Another survey, this one from Harris Poll, found that 30 percent of health professionals are dissatisfied with the technology their organization uses for secure communication. Of those who were dissatisfied with the secure communication technology at their health organization, 68 percent said this dissatisfaction was a result of different teams in the company using different technologies and 55 percent said that was because not all members of these teams had access to the same technology.
While most clinicians carry one or more mobile devices for a variety of use cases, it’s still the case that no single screen is as popular as the desktop computer for physicians, according to a survey released by Microsoft. Fifty percent of physicians used smartphones, 49 percent used laptop computers, and 23 percent used tablets, according to the survey, but 56 percent still used a desktop computer. Additionally, 55 percent still use a fax machine and 27 percent still use pagers. Thirty-nine percent still use paper.
Some 95 percent of nurses own a smartphone and 88 percent use smartphone apps at work, according to a survey of 241 nurses conducted by InCrowd.
And a Nuance Communications survey of 3,000 patients found that patients don’t have a problem with their doctors using technology during visits, as long as technology doesn’t get in the way of a meaningful interaction with their physician. Some 97 percent of patients approved of their doctor using technology (including desktop computers and mobile devices) during a consultation, and an additional 58 percent said technology positively impacts their overall experience, especially when it’s “used collaboratively to educate or explain.”
Adoption levels and gauging interest in patient engagement
A survey of healthcare leaders, conducted by The Economist, belies a lack of consensus on both the benefits of mobile health and the barriers to implementation. Some 79 respondents overall said the main role of mobile health right now is providing education and information. But, when asked to look five years into the future, most respondents saw that primary role shifting. Fifty percent said it would be “enabling patients to participate proactively in their care,” 50 percent said it would be to cut down the cost of healthcare delivery, and 29 percent said improving awareness through self-monitoring.
A small survey conducted by HIMSS found that nearly a third of healthcare providers offer organization-specific apps for their patients. In addition to the 31 percent of respondents who offer a patient app, another 30 percent are in the process of developing one. And 10 percent of respondents have created an app store to distribute apps either internally or externally.
Another survey, this one conducted by Research Now, found that 46 percent of healthcare professionals want to introduce smartphone apps into their practice within the next five years. Research Now defined healthcare professional as inclusive of doctors, nurses, and allied health professionals. While 16 percent of healthcare professionals are currently using health apps in their practice, 19 percent of healthcare professionals do not expect to incorporate health apps into their practice in the next five year.
While theres surveys indicate that patient engagement digital health to0ls are increasing and providers are interested in using them, a survey from Chillmark Research found that for any given patient engagement technology, outside of the most basic patient portals, it exists and you can find a demo of it. But an overwhelming majority of patients won’t be able to find them in their doctors’ offices.
Rao’s most optimistic estimate for when patient engagement technologies — like telemedicine, chronic disease management tools, patient generated data, and mobile apps — will be widely deployed is 18 to 24 months.
Patients also shared their views on patient engagement.
Around 65 percent of people want doctors to incorporate technology into their recommended care plans for them and 71 percent reported they would use technology to track their fitness goals, according to an online survey of 2,535 American adults, conducted by Telcare through SurveyMonkey.
Some 75 percent of US adults said it is “very important” that their important health information can be easily shared between physicians, hospitals, and other health care providers, according to a survey of 1,011 adults conducted by ORC International. Additionally, 20 percent of respondents said that they, or a family member, had experienced a problem receiving medical care because their health records could not be shared between different healthcare providers.
Patients are increasingly looking at what digital services physicians provide when choosing a doctor, and they’re finding themselves disappointed in what they see, according to a survey from TechnologyAdvice. The research group found that while 62.6 percent of physicians offered some kind of digital services, two of the top three most requested services — online appointment scheduling and online bill pay — were each offered by less than 20 percent of physicians.
Another survey, from Harris Poll, found that 64 percent of patients are willing to participate in video visits with a doctor. Of those that were willing to visit with their doctor over video, 61 percent said convenience was a factor in this decision.
And in a survey specific to seniors, Accenture found that 67 percent of seniors want to access healthcare service from home, although 66 percent of seniors do not think current available technology is sufficient for them to do so. The survey found that more than 66 percent of seniors prefer to use self-care technology to manage their health rather than managing health independently.
Payer-related digital health survey results
A survey of 1,200 consumers with either self- or employer-sponsored health insurance — sponsored by HealthMine and conducted by Survey Sampling International — indicates that interest in payer-led mobile health initiatives is still fairly low. Although 89 percent of respondents use a smartphone, tablet, or both, only 30 percent of those surveyed said they would participate in a program offered by their wellness program that would require them to use a mobile app to track or monitor their health.
Seventy one percent of consumers want their employer or health plan to offer a program or a set of guidelines that helps them manage their health, according to a recent Survey Sampling International poll of 562 consumers with company-sponsored health plans. Another 75 percent of consumers want their health plan or employer to offer incentives to help them improve their health. A smaller percentage, 66 percent of consumers, said that if their colleagues were in a healthy weight range, they should be rewarded with a discount on their health insurance.
Insurance execs also expect digital health to be a part of employee wellness programs. Two thirds of insurance company executives said they expect wearable technologies to have a significant impact on the insurance industry, according to an Accenture survey of 200 insurance company execs. They survey included perspectives from all types of insurance companies, not just health insurance.
A survey of 121 employers from Fidelity Investments and the National Business Group on Health shows that employer spending on incentive-based wellness programs is up an average of $100 per head over last year. Respondents said they planned to spend an average of $693 per employee on wellness incentives in 2015, up from $594 in 2014. It was $430 five years ago.
Health executives across all healthcare fields already seen the benefits of patient-generated data, according to an Accenture survey of 601 doctors, 1,000 consumers, and 101 healthcare executives. Some 73 percent of execs have seen positive return on investment from using technologies like wearables that track a patient’s fitness and vital signs.
Patient-related digital health metrics from H1 2015
Survey data from digital health agency Klick Health shows that diabetes patients who use digital tools to manage their health also feel healthier. Based on responses about how they use technology to manage their health, they segmented the group into three categories: those who manage their health daily or weekly with integrated digital technologies (integrators), those who go online to seek health information on a monthly basis (seekers), and those who don’t use the internet to manage their health at all (traditionalists).
The integrators group, the true digital health users, made up just 18 percent of the sample, but 13 percent of integrators reported being in excellent health. Seekers made up 47 percent of the sample and 4 percent of seekers said they were in excellent health. Finally, the remaining 35 percent were traditionalists, and only 2 percent of that group reported being in excellent health.
A majority of consumers are willing to take greater ownership of their health, according to a survey of 2,024 US adults and 516 primary care physicians. The survey found that 64 percent of respondents said they could be making more decisions about their health and wellness, 88 percent of respondents said they are confident in their abilities to take responsibility for their health, and 89 percent said they know which resources to use if they have health-related questions or concerns.
A survey of more than 1,500 teenagers in the US by the Center on Media and Human Development at Northwestern University shows that a majority of teenagers go online to look for health information, though considerably fewer use digital health tools or wearables. According to the survey, 84 percent of teens have gotten health information online.
The tools that patients can use to monitor their health are also growing more popular.
Another survey, conducted by ON World, found that 35 percent of American adults are planning to purchase a wearable technology device, and more than half of those are interested in using their wearable for activity tracking. After activity tracking, the most popular planned use cases are heart rate monitoring, sleep monitoring, blood pressure monitoring, and caring for the elderly.
A Havas Worldwide survey found that 45 percent of US consumers want a health wearable or app that monitors “every aspect” of their health. Havas also found that among worldwide early adopters, which they call “prosumers”, the percentage that want such a device increases to 70 percent. Nearly half of these early adopter prosumer group already own at least one health sensing wearable or app.
According to Parks Associates, 5 percent of US broadband households use a smart watch that offers health and fitness tracking features. Parks also found that 8 percent of US broadband households use a digital pedometer or activity tracker. Another Parks report also released this month found that 60 million US households will own at least one connected fitness tracker by the end of 2019.
According to a small survey, 82 percent of people know that the Apple Watch has health and fitness tracking features. The survey included responses from 561 consumers with company-sponsored health plans and was conducted by Survey Sampling International (SSI). The survey also found that 46 percent of respondents between the ages of 18 and 34 were interested in purchasing the Apple Watch to track their health.
These wearable devices are not just impacting the consumer market, they are also growing in popularity in enterprise. Some 33 percent of wearable tech users said fitness bands would have a large impact on enterprise and 21 percent anticipate a quick adoption rate, according to an online Salesforce survey of 500 wearable tech adopters and full-time business professionals. The respondents said they were currently using, piloting, or planning to implement wearable technology in the enterprise in some form. Additionally, 49 percent of adopters said they expected smartwatches to have a large impact on the enterprise, while 40 percent said they expected these devices to have a quick adoption rate.
But while there’s a lot of buzz about wearables and a lot of talk about tablets, the best digital channel to reach patients and consumers is still the smartphone, according to Manhattan Research’s Monique Levy. Levy said that 86 percent of the general population is online for health. Half are mobile health users of some kind, two thirds use social media to seek health information, and one third communicate digitally with doctors. Three quarters interact with online pharma resources.
GlobalWebIndex's survey of 7,500 US internet users similarly noted that the percentage of users who own smartphones is high. The survey found that 70 percent of US consumers own a smartphone, while just 5.7 percent own a fitness-sensing wristband.
But even on a smartphone, there's a variety of apps and services a user could use to manage their health.
A survey conducted by Makovsky Health and Kelton, also found that a majority of Americans were interested in using a mobile app to manage their health. This survey added that millennials were more than twice as likely to be interested in using a mobile app to manage their health compared to Americans 66 and older. Survey respondents were most interested in tracking diet and nutrition (47 percent), followed by medication reminders (46 percent), symptom tracking (45 percent), and physical activity tracking (44 percent).
A Parks Associates survey found that more than 40 million US smartphone owners are active users of at least one wellness or fitness app. The firm has also reported that one in four heads of household — at homes with broadband — use a mobile app to track their fitness or track their caloric intake.
Another study, published in Obstetrics & Gynecology, found that of the nearly 100 iOS apps focused on tracking women’s reproductive health, few have been assessed or recommended by reproductive health experts.
Almost two-thirds — 64 percent — of adults in the US now own a smartphone, according to a report from Pew Research Center. That’s up from 58 percent in early 2014. Back in 2011 Pew reported that just 35 percent of American adults were smartphone owners.
Other digital health market data published in the first half of 2015
FDA clearances for digital health devices are on track to triple by 2018, according to research from Accenture, as digital health offerings drive more than $100 billion in savings over that same time period. Thirty-three digital health devices were cleared by the FDA in 2014, according to Accenture, and they predict 100 will be cleared in 2018.
Analysts are predicting significant growth in the video visits and consultations market.
Medical video consultations and visits will increase from 19.7 million annually in 2014 to 158.4 million per year by 2020, according to a report from Tractica. The figure includes both doctor to doctor consultations as well as patient to doctor video visits.
The global home healthcare market is expected to reach $355.3 billion by 2020, growing at an estimated CAGR of 7.8 percent from 2014 to 2020, according to a report from Grand View Research. The research firm adds that the increasing adoption of telehealth offerings and other healthcare technologies are expected to drive market growth over this period.
The research firm predicts that although clinical consultations currently make up more than 75 percent of the market, growth over the next several years will be stronger in non-clinical settings and these non-clinical consultations will outnumber clinical consultations by 2019.
The global revenues for smartphone-connected fitness tracking devices and equipment will grow from $2 billion in 2014 to $5.4 billion by 2019, according to a report from research firm Parks Associates.
Two research firms are predicting that smartwatches may soon be as popular as fitness tracking devices. The NPD Group is predicting that 9 percent of American adults will own a smartwatch by the fourth quarter of 2016. Around 21 million Americans will own smartwatches at that point, NPD predicts, while 32 million will own dedicated activity trackers. But the firm projects that activity tracker adoption will peak at 32 million, while smartwatch adoption will continue to grow, potentially eclipsing activity trackers over the next few years.
A survey of more than 1,000 consumers from ON World showed that fitness is the most important application for wearable users. More than half of likely wearable device owners would use their devices, either activity tracking devices or smartwatches, for fitness. Although smartwatches are enjoying some time in the spotlight, ON World’s research shows consumers still have a healthy interest in dedicated fitness activity tracking devices: 39 percent of likely wearable consumers expressed an interest in such devices, a jump of 22 percent since ON World’s 2014 survey. But ON World predicts that in five years general purpose smartwatches with fitness apps, such as the Apple Watch, will make up more than 70 percent of the smartwatch market.
Prior to the Apple Watch launch, Canalys reported that the market leader for “smart wearable bands” — any wristworn device that can run third-party applications — is Samsung. Meanwhile, the “basic wearable band” market, which Canalys defines as wearables that can’t run apps, is still led by Fitbit, which has since filed for an IPO.
Another report found that Fitbit had the most shipments and a 34.2 percent market share, down from 44.7 last year, in the first quarter of 2015, but following Fitbit is Xiaomi, which had 24.6 percent market share even though the company had just started shipping devices during the second half of 2014.
TechNavio reported that the smart fitness and sport wearable device market is expected to grow at a CAGR of 25.4 percent globally and the smart fitness and health services market is expected to grow at a CAGR of 29.9 percent from 2014 to 2019.
Juniper Research predicts that connected healthcare and fitness device services will produce $1.8 billion in annual revenues by 2019, a sixfold increase from 2015, which has predicted revenues of $320 million. The services market is due to explode because in order to succeed, connected fitness devices will have to shift their focus from just hardware, to software and services, the firm explains.
As more and more health sensors are built into mobile devices, the global biometrics market is ramping up. The most recent prediction is that the market will hit $14.9 billion by 2024, up from $2 billion in 2015, according to a report from Tractica. The biometrics market will see a compound annual growth rate (CAGR) of 25.3 percent and cumulative revenue of $67.8 billion for the ten-year period, according to the firm.
Tractica also predicts that worldwide unit shipments of clinical and non-clinical connected wearable patches will grow to 12.3 million per year by 2020. Last year, annual shipments were just 67,000. The market for such connected patches, Tractica predicts, will hit $3.3 billion per year.
Another Tractica report found that smart clothing shipments are expected to surpass 10.2 million units annually by 2020, up from 140,000 units in 2013. Tractica explained that currently, sport enthusiasts are leading adoption of smart clothing, which Tractica defines as clothing that monitors muscle activity, breathing rate, and heart activity zones, but over the next few years, these items will gain traction with the mass consumer market.
Tractica also predicted that the number of people using home health technologies will increase from 14.3 million worldwide in 2014 to 78.5 million by 2020. In Tractica’s view, home health technologies include offerings that allow providers to remotely monitor patients with chronic conditions, use technology to improve care for elderly people, and conduct virtual visits with a physician.
In Europe, the top five markets for mobile health app companies include Denmark, Finland, Netherlands, Sweden and the United Kingdom, according to a survey of 5,000 app developers, healthcare professionals, and digital health practitioners. The survey, which was conducted by Research2Guidance in collaboration with HIMSS Europe, found that 55 percent of respondents ranked the UK as the top market.
Allied Market Research released a report that found the global mobile health market is expected to grow at a compound annual growth rate of 33.5 percent between 2015 and 2020.
Back in the US, Rock Health released a report the analyzed the gender gap in digital health. The report found that 6 percent of venture-backed digital health companies have female CEOs. Additionally, women make up 21 percent of board members as Fortune 500 healthcare companies, 27 percent of board members at top 100 hospitals, and 34 percent of executives at top 100 hospitals. A Rock Health survey, conducted by Rock Health’s XX in Health initiative, found that 96 percent of the 421 women working in healthcare who responded believe gender discrimination still exists and 45 percent say gender discrimination and lack of respect are their biggest hurdles. Fifty percent of respondents said they had to adopt male behaviors to advance their career and 33 percent said being a female is disadvantageous to their career.